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Adults with multiple sclerosis (MS) and associated walking impairment in England are now eligible for NHS treatment with fampridine, bringing the country in line with access in other UK nations, NHS England has said.
In a statement published on 23 July 2026, NHS England said that the new treatment — taken as a twice-daily tablet and discontinued if walking speed does not improve by more than 20% after two to four weeks — is likely to benefit around 5,000 patients in the first year.
The drug was recommended for use on the NHS in England via a clinical commissioning policy published on 16 July 2026.
The medicine aids nerve signalling by retaining potassium in the nerve, thus improving walking speed by an average of 25% in some patients, according to the MS Society.
Fampridine is also known by brand name Fampyra (Merz Therapeutics), but the UK patent ends in July 2026.
The Medicines and Healthcare products Regulatory Agency (MHRA) has approved several generic versions of the drug.
Fampridine has been available on the NHS in Wales since 2019, in Scotland since 2020 and in Northern Ireland since 2023. However, in England, a National Institute for Health and Care Excellence (NICE) review, published in 2022, said the medicine was “not cost effective at the current list price”.
Ceri Smith, head of policy and evidence at the MS Society, told The Pharmaceutical Journal on 23 July 2026 that a reduction in the cost of fampridine was a “key trigger” in NHS England recommending the drug at this time.
Currently, some patients in England do have access to the drug privately, but the cost is high for the “life-changing” drug, which is typically between £200 and £600 per month, Smith said.
Smith added: “It’s absolutely transformative in terms of their ability to walk, and it has an effect beyond that for a lot of people that goes beyond its licensing in terms of impact on dexterity and fatigue. It does really support people to be able to stay in work and to function at a level that that they wouldn’t be able to without the drug.”
However, she said that more work would be needed to build the infrastructure to enable patients to access the drug in all four UK nations.
“There are some services that are better prepared to start prescribing fampridine than others, where it would require quite a lot more work. And our services are pretty stretched at the moment. For some areas, this will be very difficult to get set up [and clinicians] will require quite a lot of support,” Smith continued.
“So that’s why we’re calling on commissioners to really ensure that MS services have the resources to be able to run the clinics required to prescribe fampridine.”
In addition, she said that the recommendation via an NHS England commissioning policy rather than through NICE means “there’s not a requirement on ICBs [integrated care boards] to have it on their formulary or to regularly prescribe it”.
The treatment will be commissioned and funded by NHS England under existing arrangements for the provision of specialised services, NHS England said, adding that as a high-cost drug, it will be reimbursed under the cost and volume process.
In its clinical commissioning policy for fampridine, NHS England suggested that service provision in England may have greater capacity than other UK nations to review patients for the treatment, and therefore an estimated 5,000 people could access the treatment within the next year.
Fampridine’s marketing authorisation is for adult patients with MS with walking disability, which is defined as having an Expanded Disability Status Scale (EDSS) score of 4 (ambulatory without rest for >500 meters ) to 7 (unable to walk five meters even with aid, essentially restricted to wheelchair for around 12 hours a day).
The clinical commissioning policy highlighted that trial results have revealed that the medication will be effective in around 43% of MS patients with walking impairment.
However, in the past year, a higher proportion than this have remained on the treatment in Wales, suggesting that more patients in England might benefit too, it added.
NICE recommends that the treatment should be avoided in patients with a history of renal failure or epilepsy, or who take cimetidine (Tagamet; Rosemont Pharmaceuticals) or dolutegravir (Tivicay; ViiV Healthcare), which can both increase the concentration of fampridine.
