NICE backs Celgene’s thalidomide and Janssen’s Velcade
pharmafile | June 21, 2011 | News story | Sales and Marketing | NICE, Thalidomide, Velcade, multiple myeloma
Celgene’s thalidomide and Janssen-Cilag’s Velcade have been given the thumbs up by NICE as a treatment for a cancer that develops from cells in the bone marrow.
The final draft guidance recommends them both for multiple myeloma, with thalidomide prefered ahead of Velcade – confirming a decision made by NICE a year ago, which was challenged by Janssen.
The two drugs are similar in terms of clinical effectiveness, but NICE had favoured Celgene’s treatment for providing better value: thalidomide will cost the NHS £2,100 for an average treatment cycle versus £3,000 for Velcade.
But an appeal panel upheld one of Janssen’s points, stating that “insufficient efforts had been made by NICE to obtain permission to release an executable economic model to consultees”.
The owners of confidential data contained in the model agreed to make it known and the appraisal committee met again to discuss the model’s reliability and reconsider the first draft recommendations.
But NICE has arrived at the same conclusion in the new draft: thalidomide is to be used in combination with an alkylating agent and a corticosteroid as first-line treatment in people for whom high-dose chemotherapy with stem cell transplantation is considered inappropriate.
Velcade is only recommended in a similar combination for the same patients if the person is unable to tolerate, or has contraindications to, thalidomide.
“The evidence clearly showed that both thalidomide and bortezomib regimens are more effective at delaying disease progression and improving patients’ life expectancy than the current treatment of an alkylating agent and corticosteroid alone,” said Dr Carole Longson, NICE’s Health Technology Evaluation Centre director.
Longson added that clinical specialists had confirmed a thalidomide regimen would be considered more suitable for most patients.
However, Velcade is still “considered an appropriate and cost effective treatment option”, she concluded. Final guidance is expected to be published next month.
In the UK, an estimated 3,500 new cases of multiple myeloma are diagnosed each year, with 10,000-15,000 patients currently living with the disease. There is currently no cure.
Adam Hill
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