The NHS North East Treatment Advisory Group (NETAG) has issued a recommendation and associated appraisal report on the use of amifampridine phosphate (Firdapse®) for the symptomatic treatment of Lambert-Eaton Myasthenic Syndrome (LEMS).  The Group does not recommend its use except where interruption to therapy with amifampridine is considered to present a critical clinical situation.  This recommendation is contingent on a discounted price specified within a patient access scheme and only if the use of amifampridine is a continuation of therapy in accordance with existing commissioning arrangements.