The North East Treatment Advisory Group (NETAG) has published an appraisal report and associated recommendations regarding the use of amifampridine phosphate (Firdapse®) for Lambert-Eaton myasthenic syndrome.

The Group does not recommend the use of Firdapse® for Lambert-Eaton myasthenic syndrome within NHS North East.  The main points noted in the decision summary are as follows:

• All clinical evidence originated from studies of amifampridine base. 
• Firdapse® is currently substantially more costly than equivalent doses of unlicensed amifampridine (3,4-diaminopyridine) – with annual costs of around £30,000-45,000 and £1,500-£2,200 per patient, respectively
• The group did not consider Firdapse® to be a cost-effective treatment contingent on the continued availability of the unlicensed product.  
• The group was mindful of guidance from professional and regulatory authorities regarding the use of unlicensed medicines, but also noted the apparent extensive experience of using unlicensed amifampridine and the absence of issues arising from this.

The decision summary and the related appraisal report (background information and evidence summary) can be accessed via the links below.