The New Brunswick Medical Society has asked the provincial government to stop giving money to patients with multiple sclerosis who want to obtain liberation therapy outside Canada.
Dr. Robert Desjardins, president of the New Brunswick Medical Society (NBMS), says the therapy, which involves using angioplasty to open constricted veins in the neck and chest, has not been proven to be clinically effective. “NBMS always bases its recommendations for the use of public money on evidence,” he says.
Liberation therapy, which is not approved in Canada, was first proposed by Italian doctor Paolo Zamboni in 2009, based on the idea that the narrowing of the large veins in the neck and chest — a condition called chronic cerebrospinal venous insufficiency (CCSVI) — hampers the drainage of blood from the brain, resulting in damage to brain tissue that can cause multiple sclerosis. Since then, nearly 30 000 people around the world have had the angioplasty treatment.
But recent studies have cast doubt on the effectiveness of liberation therapy. In February, a paper in the Annals of Neurology found no evidence that CCSVI was more prevalent in people with multiple sclerosis than in healthy controls (onlinelibrary.wiley.com/doi/10.1002/ana.23839/full). In March, researchers at the University at Buffalo, The State University of New York, announced that they found no clinical benefit from the therapy for patients with multiple sclerosis in a phase II clinical trial — and that in some cases the symptoms got worse (www.eurekalert.org/pub_releases/2013-03/uab-mpd031413.php#).
New Brunswick is the only province that provides funding for patients to travel outside Canada to receive the treatment. A single treatment can cost up to $10 000. New Brunswick provides up to $2500 to match funds raised from the patient’s community or a third-party donor. Since the program’s inception in April 2011, 84 people have received funding, for a total of $210 000. The number of applications has fallen off recently, though, and the budget for the program this year is $75 000.
“It’s a negligible amount on the provincial scale, but it could be better spent on other, more effective, therapies,” says Desjardins.
The program was promised in the New Brunswick Progressive Conservative party’s 2010 election campaign but may be losing political support. After the results from the University at Buffalo study, independent member of the legislative assembly and retired surgeon Dr. Jim Parrott called for the funding to be scrapped. Finance Minister Blaine Higgs, whose department administers the fund, and Health Minister Ted Flemming said in May that the fund could be reconsidered, and that they would seek the advice of the province’s doctors.