COVID-19: Multiple Sclerosis Treatment Assessment Committee (MSTAC) Applications
Renewal applications during the COVID-19 response
For patients with Special Authority approvals that are due to expire in March, April and May 2020 – we are extending the Special Authority by 3 months without requiring a renewal application.
This will be a manual process. We will email clinicians to confirm the extensions. This may take a few days. Clinicians will need to let patients know if they have had an extension to their approval; we are unable to do this.
After this initial extension, we anticipate that the clinician will need to renew the application as usual, but with the changes outlined below.
Already organised or had a telephone assessment for patients being given 3 month extensions
Some clinics have already organised or held a phone assessment with a patient who is getting a 3 month extension. Please continue to conduct assessments where possible.
This will allow us to renew the application for 12 months. The 3 month extension is intended as leeway in case phone assessments can't be completed before a patient's approval expires.
Clinical criteria for MSTAC applications
While the Special Authority criteria for ongoing use of MS treatments require an EDSS assessment and relapse summary, we consider that assessment of this can be reasonably done by consulting with the patient remotely (eg. via telephone or videoconference).
We would also be happy to consider extensions to approvals, on a case-by-case basis, where phone or video consultation could not be used in time for a renewal application.
The Multiple Sclerosis Treatments Committee (MSTAC) has developed guidance for clinicians when using telephone assessment for renewal applications.
Use the standard MSTAC renewal form when completing an application.
- Ask about relapses and complete the required information as per the MSTAC renewal form.
- When assessing EDSS via the telephone, ask if anything has significantly changed since the last time EDSS was assessed.
- Ask how far the patient is able to walk and what, if any, assistance is required.
- If there has been no change or an improvement in EDSS, then use last year’s EDSS score or the estimated lower score in the case of improvement.
- If there is an increase in EDSS then use this score. You can score based on estimated ambulation.
Refer to the MSTAC renewal document for EDSS scores at different levels of ambulation.
If your patient meets EDSS stopping criteria because their ambulation has worsened on telephone assessment, we consider that, due to the limitations with telephone assessment, these patients would be approved for a further 6 months.
They will then need a renewal consultation before the end of the 6-month period.
Who to contact
If you have any questions:
> email email@example.com
> phone 0800 023 588 option 1.
Last updated: 15 April 2020