20 years is an absurd, out-of-touch estimate. Certainly the resistance in the medical community to treat a presumed not serious condition like CFS with a serious drug like Ritux will be the problem. I guess this question is a little confusing because the drug already is widely available, but is not approved by any insurance to treat CFS. AFAI coverage for M.S. drugs isn't even even great or 100%, so I would expect insurance would only cover a portion. The insurance argument would demand another phase III trial, so probably at least 3 years plus a year of bureaucracy. So 4-5 years. I believe it will be tested in the NIH in-house study, Nath said he wants to try drugs in the second phase and Ritux is the only drug with convincing evidence behind it (given the thread's assumptions).
Another angle is "biomarker" or convincing test for CFS probably plays a role in how willing insurance will be to cover a drug for fatigue. They, and we, don't want somebody who has mild chronic fatigue but not CFS on a drug like Ritux after only 6 months. I'm not sure how the logistics of it would work. This is in the U.S., I have no idea how a socialist country would handle it. I'm sure 4-5 years is a good guess for a country like Norway, but the U.K. could be a lot looonger.
In the short term, I suspect if it works we will be making a trip to a country to take it cheaply and travel there every 6 months or so. I have no idea what the risks or with JVC past a few years, though.
Actually, that's a good question - if the drug works, and say works for me, is it safe to take for a decade until something better comes along? Does anyone know who would have a good answer to that question.