Time matters in MS – an International Roundtable

Watch the Roundtables Podcasts Programme & Slides Faculty


A therapeutic strategy that calls for early intervention and regular monitoring of disease activity offers the best chance of preserving brain health and achieving the best possible outcome for people with MS. Support from clinicians underpins the success of such evidence-based strategy but recognition from regulatory bodies, health technology assessors and payers that access to therapies and monitoring technologies needs to be improved is also required. BMJ and JNNP hosted an international round table “Time Matters in MS” on World MS Day 2017 that addressed these questions which you can watch at your convenience.

Watch the Roundtables


Time Matters – part 1: delay is “expensive” in all aspects of multiple sclerosis

Professor Emeritus Alastair Compston (University of Cambridge) discusses with JNNP’s Publisher Janet O’Flaherty the issues raised by the discussion “Brain health matters in multiple sclerosis” (MS), which was part of the international roundtable “Time Matters in MS”, organised by the BMJ and the JNNP on World MS Day 2017, in Lisbon.

Time Matters – part 2: How the real costs of MS are being concealed

“Take a comprehensive economic approach to evaluating treatment cost-effectiveness in MS”. Jacqueline Palace (Consultant Neurologist, Nuffield Department of Clinical Neurosciences, University of Oxford) and Ruth Geraldes (Neurologist, Department of Clinical Neurosciences, University of Oxford) examine the economic burden of multiple sclerosis, which was debated at the international roundtable “Time Matters in MS”, organised by the BMJ and the JNNP on World MS Day 2017, in Lisbon.


Session 1: Brain Health Matters in MS

Chair, Alastair Compston
Professor Emeritus, University of Cambridge

  • Looking at the interaction between MS and vascular co-morbidities
    Ruth Geraldes
    Neurologist, Department of Clinical Neurosciences, University of Oxford
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  • Never Stop Trying to Stop MS
    Klaus Schmierer
    Reader in Clinical Neurology, Blizard Institute, Barts and the London School of Medicine and Dentistry
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  • Before it is too late: why time matters in MS
    João José Cerqueira
    Assistant Professor, Universidade do Minho, Braga
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Session 2: Take a comprehensive economic approach to evaluating treatment cost-effectiveness in MS

Chair, Jacqueline Palace
Consultant Neurologist, Nuffield Department of Clinical Neurosciences, University of Oxford

  • New insights into the burden and costs of MS in Europe
    Alan Thompson
    Dean, Faculty of Brain Sciences, University College London
  • Using IMPrESS (International MultiPlE Sclerosis Study) to guide policy change in multiple sclerosis
    Michela Tinelli
    Senior Research Associate, LSE Enterprise, London School of Economics
    Assistant Professorial Research Fellow, PSSRU, London School of Economics
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  • Strategies to get relevant health economics data from the clinical development pre-marketing phase of MS products
    Mario Miguel Rosa
    Neurology Professor; Clinical Pharmacology Professor, Faculty of Medicine, University of Lisbon
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Alastair Compston CBE, FRCP, FMedSci, FRS

Professor Compston was formerly professor of neurology, University of Cambridge, and is now professor emeritus. He is a former president of the European Neurological Society and the Association of British Neurologists as well as editor of Brain. Professor Compston is a Fellow of the UK Academy of Medical Sciences, Foreign Member of the National Academy of Sciences of Germany, Foreign Associate Member of the National Academy of Medicine of the USA, and Fellow of the Royal Society of London. His research focuses on the clinical science of human demyelinating disease which has been recognised by international prizes that include the Charcot Award of Multiple Sclerosis International Federation, the World Federation of Neurology Medal for Scientific Achievement in Neurology, the John Dystel Prize of the American Academy of Neurology and the National Multiple Sclerosis Society of the USA, the Hughlings Jackson Medal of the Royal Society of Medicine, and the Association of British Neurologists Medal.

Ruth Geraldes

Dr Geraldes is a neurologist at the Department of Clinical Neurosciences, John Radcliffe Hospital in Oxford. She has a special interest in inflammatory disorders of the central nervous system, particularly multiple sclerosis. Dr Geraldes completed her neurology training at Santa Maria University Hospital in Lisbon, Portugal, where she worked for 5 years involved in MS patient care and clinical trials. She is currently working as the MS Clinical Fellow at Oxford University Hospitals looking into the interaction between vascular disease and MS through post mortem and brain MRI studies.

Klaus Schmierer, MBBS, PhD, FRCP

Dr Schmierer is Reader in Clinical Neurology and a Consultant Neurologist at Blizard Institute, Barts and the London School of Medicine and Dentistry. Multiple sclerosis has been a focus of his clinical and research activities from the beginning of his training in neurology at the Charité Hospital (Humboldt University Berlin). In 2001 he moved to London to pursue a career in academic neurology, initially as a Research Fellow, and from 2005 as a Wellcome Intermediate Clinical Fellow at the UCL Institute of Neurology, and Consultant Neurologist at The National Hospital, Queen Square. Here, Dr Schmierer investigated histopathological correlates of quantitative MRI using standard and high-field MR systems to improve disease monitoring in people with MS. His clinical academic work now includes exploring the pathological substrate of disease deterioration in pwMS using MRI and quantitative histology; studies into the epidemiology and cause(s) of MS/the Barts MS Database; in vivo MRI studies to improve the differential-diagnosis of MS; and investigator-led and commercial clinical trials.

From 2013-15 he was a member of the Association of British Neurologist’s MS & Neuroinflammation Specialist Subcommittee which published the latest disease modifying treatment guidelines for people with MS. He is the clinical lead of neuroscience & trauma at the Blizard Institute of QMUL and Deputy Director of the Research & Development Board in the Emergency Care & Acute Medicine Clinical Academic Group of Barts Health NHS Trust. He is Past-Chair of the White Matter Study Group of the International Society for Magnetic Resonance in Medicine, and serves on the MS Society’s Clinical Trials Network, as well as the review boards of the MS Tissue Bank and MS Register. He has advised the EMA, MHRA and NICE on new drugs for MS.

João José Cerqueira

Professor Cerqueira is Associate Professor of Neurology at the School of Medicine, University of Minho and Head of the Neuroimmunology Clinic, at the Hospital de Braga. He is currently the director of the MD program at Minho and president-elect of the Portuguese MS Study Group. His research interests focus on the mechanisms underlying cognitive decline in a variety of conditions, from ageing and stress to neuroimmunological disorders, and strategies to overcome it. He is the author of more 60 papers, which have been cited more than 2000 times, with an h-index of 19.

Jacqueline Palace

Professor Palace is a consultant neurologist in Oxford and Associate Professor of Nuffield Department of Clinical Neurosciences, Oxford University. She leads the Oxford Multiple Sclerosis group and runs a national service for congenital myasthenia and jointly a UK neuromyelitis optica service. Her MS service comprises a regional clinical service and a clinical research group. Research interests include clinical treatment trials, immunological studies, pathology, biomarkers, genetics and imaging studies on neurodegeneration and its detection and association with inflammation. She was a UK lead for the National Risk Sharing Scheme which assessed the long-term effectiveness for disease modifying agents in multiple sclerosis and is now complete.

Alan J Thompson, FMedSci, FRCP, FRCPI, FAAN, FANA

Professor Thompson is Dean of the Faculty of Brain Sciences at University College London, Garfield Weston Professor of Clinical Neurology and Neurorehabilitation at the UCL Institute of Neurology, a consultant neurologist at the National Hospital for Neurology and Neurosurgery, Queen Square, and Chair of the Neuroscience Academic Medical Centre, UCLP Academic Health Sciences Centre in London. His main area of expertise is the diagnosis, evaluation, and management of the progressive forms of multiple sclerosis. He has focused on the pathological mechanisms that underpin neurological disability, and on recovery through neurorehabilitation.

As Dean of the Faculty of Brain Sciences he leads comprehensive programmes of research in dementia and mental health and led UCL’s successful bid for the Hub of the UK Dementia Research Institute (£250 million). As neuroscience lead for UCL Partners he has jointly led innovation in treatment pathways for stroke and brain cancer. Professor Thompson has published extensively in high-impact journals. He is chair of the Scientific Committee of the International Progressive MS Alliance, a Senior Investigator Emeritus for the National Institute for Health Research, Editor-in-Chief for Multiple Sclerosis Journal, and a Guarantor of Brain.

Dr Michela Tinelli

Michela Tinelli holds the position of Assistant Professorial Research Fellow at the Personal Social Services Research Unit, London School of Economics and Political Science. Michela’s research is primarily concerned with the evaluation of patient experience, burden of the disease and the socio economic impact of people-centred and integrated health service approaches in individuals with chronic illnesses and hard to serve populations.

Michela is currently acting as health economics expert for the Value of Treatment Programme (VoT), EU based collaboration with a consortium of more than 30 European partner institutions (including LSE), led by the European Brain Council. The purpose of the programme is to explore the potential for integrated care model for brain disorders to close the treatment gap in Europe. As part of the VoT programme she is working with Martin Knapp at LSE and the EBC partners to assess the socio-economic impact and value of different healthcare interventions with application to a series of brain disorders, including: dementia, epilepsy, headache, idiopathic normal-pressure hydrocephalus, multiple sclerosis, Parkinson’s disease, restless legs syndrome, schizophrenia and stroke.

Michela has recently worked with Panos Kanavos at LSE on an international project that explored the social economic costs, quality of life and experience in individuals with multiple sclerosis (MS) and their carers and compared the burden of the disease and early management in multiple sclerosis across healthcare settings.

A quantitative researcher, she has specialist skills in stated preferences techniques and other benefit evaluations in health policy developments, including clinical outcomes, health related quality of life, and patient satisfaction, which she has applied in benefit and economic evaluations. She has also expertise in survey development and design.

Mario Miguel Rosa, MD, PhD

Dr Rosa is a  neurology consultant and clinical pharmacologist who has been based at Hospital Santa Maria (CHLN) – Neurology Dept and Faculdade de Medicina da Universidade de Lisboa (FMUL) since 1990, where he has been practicing and participating in clinical trials as subinvestigator, investigator and national coordinator 1990-2011. Since then he has focused clinical investigation mostly in degenerative disorders and pharmacoepidemiology–pharmacoeconomy. In 1995 he was appointed pharmacology consultant to INFARMED – the Portuguese drug authority, for risk management in neurology, and extended to reimbursement in 1998.

He is a member of the Medicines Evaluation Committee and Health Technologies Appraisal System at INFARMED, IP. Working as an external expert with the European Medicines Agency since 2005, he is now a senior expert. He was selected as a member of the Scientific Advice Working Party at EMA in 2011, where drug developers seek advice on how to proceed with development plan of new agents. He is also a member of Central Nervous System Working Party and an expert to the Geriatric Expert Group.

Dr Rosa has been a member of the Ethics Committee of CHLN-FMUL since 2004, Fundação Champalimaud since 2012 and CNS since 2016. He is interested in medical ethical issues especially those related to drug development. Dr Rosa is Professor of Neurology and Clinical Pharmacology at FMUL and also the Head of the Lisbon Pharmacovigilance Unit at the National Pharmacovigilance System. He has published 10 book chapters in movement disorders, clinical pharmacology and drug safety, 56 original papers in peer reviewed publications and has presented more than 190 oral communication in neurology, drug safety, pharmacoepidemiology and evidence based medicine.

Contact Us

For more information please contact JNNP Publisher Janet O’Flaherty.


The event was supported by an unrestricted educational grant from F. Hoffmann-La Roche and Roche Farmacêutica e Química.