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Ocrelizumab (Ocrevus) for MS, IV or the new 10-minute injection.

A high-efficacy B-cell-depleting DMT for relapsing and primary progressive MS - with the new subcutaneous route turning a half-day infusion into ten minutes, twice a year, either at the clinic or at home.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private ocrelizumab costs in the UK.

Indicative ranges across our partner MS units.

In short

Private ocrelizumab in the UK: £5,000–£9,000 per dose, every six months.

Treatment Indicative range
Ocrelizumab IV infusion (per dose, every 6 months) £5,500–£8,500
Ocrelizumab SC injection (per dose, every 6 months) £5,000–£9,000
MS neurology consultation (initial) £300–£500
Baseline workup (bloods, hep screen, immunoglobulins) £350–£650
MRI brain and spine with contrast £950–£1,600
Follow-up monitoring (per visit) £200–£350

Prices vary by centre, by route (IV or SC), and by whether monitoring is bundled or itemised. NHS access is available where NICE criteria are met (TA533 for RRMS, TA585 for PPMS) - we always compare against that first.

The problem

The right DMT, the right route, the right monitoring.

Ocrelizumab is a high-efficacy DMT with a genuinely new subcutaneous option - and a real safety-monitoring load. Neither should be treated as routine, and neither should be booked in blind.

  • Not sure it is the right DMT?

    Ocrelizumab is one of several high-efficacy options. A named MS neurologist compares it honestly against natalizumab, ofatumumab and cladribine.

  • IV or subcutaneous?

    A 2-hour infusion or a 10-minute injection - the answer depends on your life, your veins, and what your MS unit currently offers.

  • Worried about long-term safety?

    Hypogammaglobulinaemia, hepatitis B, live vaccines and PML - we build a proper monitoring plan, not a leaflet.

When it helps

When ocrelizumab is the right DMT.

The clinical situations we see most, plus the one red flag that means treat first, dose after.

  • Relapsing-remitting MS (active)

    RRMS with clinical relapses or new MRI activity despite a first-line DMT - a classic ocrelizumab indication.

  • Primary progressive MS (early)

    PPMS with early progression and inflammatory MRI features - ocrelizumab is the only licensed DMT for PPMS.

  • Highly active RRMS from onset

    Aggressive disease with frequent relapses or heavy MRI load - a high-efficacy DMT is the right first step.

  • Breakthrough on platform therapy

    New relapses or lesions on interferon, glatiramer, teriflunomide or dimethyl fumarate - time to escalate.

  • JCV-positive on natalizumab

    Natalizumab working but JCV-positive with rising PML risk - ocrelizumab is a common switch, with no JCV constraint.

  • Convenience over IV chair time

    The SC route offers 10 minutes twice a year rather than a half-day infusion chair - a real quality-of-life shift.

  • Planning a family later

    B-cell depletion allows a wash-out window before conception - planning is possible with the right timing.

  • Red flag: active infection or hep B

    Active infection, untreated hepatitis B or severe immunosuppression are contraindications - treat first, dose after.

Treatment options

Ocrelizumab is not the only high-efficacy option.

What each route and each alternative actually involves - and which fits which patient.

  • Ocrelizumab IV (original route)

    A 2-hour infusion in a day-case chair every 6 months. Long-established, NHS-funded via NICE TA533 (RRMS) and TA585 (PPMS).

  • Ocrelizumab SC (new route)

    A 10-minute subcutaneous injection at the clinic or at home by a nurse. MHRA-licensed; NHS availability expanding through 2025–2026.

  • First-dose IV split-dose protocol

    Historically the first 600mg dose was given as two 300mg infusions two weeks apart. Newer protocols allow a single first dose in selected units.

  • Switch from natalizumab

    A structured switch - wash-out window, MRI check for PML surveillance, then ocrelizumab. Timing matters and is neurologist-led.

  • Switch from a platform DMT

    Stopping interferon, glatiramer, teriflunomide or DMF and starting ocrelizumab - usually straightforward with no long wash-out needed.

  • Switch from ofatumumab or rituximab

    Another anti-CD20 already on board - timing of the next dose is coordinated to avoid over-depletion.

  • Alternative anti-CD20 (ofatumumab)

    A self-administered monthly subcutaneous anti-CD20 - different rhythm, similar mechanism. We compare honestly.

  • Consultation only

Safety and monitoring

What to plan for on ocrelizumab - honestly.

Ocrelizumab is a high-efficacy DMT with a well-characterised safety profile. The things worth planning are your vaccine timeline, your immunoglobulin trend and your pregnancy window.

  • Injection or infusion reactions

    IV reactions (rash, itching, throat tightness) are most common on the first dose and settle with pre-medication. SC gives more local site reactions but far fewer systemic ones.

  • Upper respiratory infections

    Coughs, colds and sinusitis are the commonest side effect. Usually mild, but tell the team about anything that lingers or comes with a fever.

  • Hypogammaglobulinaemia over time

    Immunoglobulin levels can fall with repeated dosing. We measure IgG and IgM before every dose and act on a downward trend before serious infection appears.

  • Hepatitis B reactivation

    Untreated hepatitis B can reactivate on anti-CD20 therapy. Screening is mandatory before starting; if positive, prophylactic antivirals are used.

  • PML - very rare, not zero

    Progressive multifocal leukoencephalopathy is extremely rare on ocrelizumab (a handful of cases worldwide) - much lower than natalizumab. MRI surveillance still applies.

  • Live vaccines are contraindicated

    Live vaccines (MMR, yellow fever, live shingles) must be given before starting ocrelizumab. Inactivated vaccines are safe but response is reduced.

  • Breast cancer - a small signal

    A small increased risk of breast cancer has been reported in trials. Routine breast screening is recommended; discuss with the neurologist if you have a family history.

  • Pregnancy planning matters

    B-cell depletion persists for months after a dose. A wash-out window of six to twelve months before conception is usually advised.

  • Red flags

    New neurological symptoms, persistent fever, severe headache, cognitive change or a rash - contact the MS team the same day, not next week.

Reading your dosing note

Your dosing note in four parts. Read the last one first.

Whichever route was used, the note the MS neurologist sends you keeps to the same shape.

A UK consultant MS neurologist reviewing a patient’s dosing notes

A quiet reminder

Neurology language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your next review, just ask.

  1. 01 Header

    Diagnosis, MS type and DMT history

    Whether the diagnosis is RRMS or PPMS, previous DMTs tried, and why ocrelizumab is being started or continued.

  2. 02 Technique

    Dose, route and premedication

    Dose (usually 920mg SC or 600mg IV), route (IV or SC), premedication given, and whether observations were unremarkable.

  3. 03 Findings

    Bloods, MRI and infusion reaction notes

    Latest FBC, LFTs, immunoglobulins and JCV status. Any MRI changes since last dose, and any infusion or injection reactions.

  4. 04 Impression

    Next dose, monitoring and safety-net

    Read this first: date of the next dose, when the next bloods and MRI are due, and what to do if you feel unwell before then.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for high-cost DMTs like ocrelizumab varies by insurer and by policy.

Frequently asked

Everything we get asked about ocrelizumab (Ocrevus).

Quick answers on IV versus SC, efficacy, monitoring, pregnancy and cost.

  • What is ocrelizumab (Ocrevus) and how does it work?

    Ocrelizumab is a humanised monoclonal antibody that targets CD20 on B cells and profoundly depletes them. B cells drive much of the inflammation in MS, so removing them reduces relapses and slows disability progression in both RRMS and PPMS.

  • What is the difference between IV and subcutaneous ocrelizumab?

    The original IV formulation is a two-hour infusion every six months in a day-case chair, usually with pre-medication. The new subcutaneous formulation is a 10-minute injection into the thigh or abdomen, every six months, with no pre-medication typically required. Efficacy is non-inferior in the OCARINA I and II trials.

  • Is the subcutaneous version of Ocrevus available on the NHS in the UK?

    The SC formulation is MHRA-licensed following EU and US approvals in 2024–2025. NICE is reviewing it and NHS availability is expanding through 2025–2026. Availability varies by MS centre; private access is already possible in selected clinics.

  • How effective is ocrelizumab for MS?

    In the OPERA I and II trials in RRMS, ocrelizumab reduced relapse rate by roughly 46% and disability progression by roughly 40% compared with interferon beta-1a. In the ORATORIO trial in PPMS, it reduced progression by roughly 24% - the first DMT with a licensed PPMS indication.

  • Do I need to be JCV negative to take ocrelizumab?

    No. Unlike natalizumab, JCV status does not gate ocrelizumab. PML has been reported very rarely on ocrelizumab (a handful of cases worldwide), so MRI surveillance still applies, but JCV testing is not a routine gatekeeper.

  • What monitoring is needed on ocrelizumab?

    Baseline hepatitis B, C and HIV serology, immunoglobulins, FBC, LFTs and MRI. Between doses: FBC, LFTs and immunoglobulins to catch hypogammaglobulinaemia. MRI every 6–12 months. Vaccine planning before starting - live vaccines are contraindicated on treatment.

  • Can I have children while on ocrelizumab?

    Yes, with planning. B-cell depletion persists for months after a dose, so a wash-out window of six to twelve months before conception is usually advised. Discuss timing with the MS team before stopping contraception.

  • How much does private ocrelizumab cost in the UK?

    Roughly £5,500–£8,500 per IV dose and £5,000–£9,000 per SC dose (given every six months), plus consultation, MRI and monitoring fees. NHS access is available where NICE criteria are met (TA533 for RRMS, TA585 for PPMS).

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