NICE recommends Victrelis in speedy review
pharmafile | March 9, 2012 | News story | Sales and Marketing | Incivo, Janssen, Merck, NICE, Pegasus, Victrelis
NICE is recommending Merck’s hepatitis C pill Victrelis for funding in the NHS, in an expedited review.
In its final draft guidance, NICE recommends Victrelis (boceprevir), in combination with Roche’s Pegasus (peginterferon alfa) and Copegus (ribavirin) injections, as an option for the treatment of genotype 1 chronic hepatitis C in adults with compensated liver disease.
The drug has bypassed the preliminary stages of the NICE appraisal process, meaning it should receive the watchdog’s final endorsement next month.
This is because the condition has a poor diagnosis and low treatment compliance rate, with a high annual incidence of new infection.
All of this means that despite the availability of current treatments, chronic hepatitis C presents a major public health challenge, and requires new medicines like Victrelis that represent a step-change in treating the disease.
The drug is priced at £2,800 for a 28-day, 336-tablet pack and costs £30,800 for a 44-week course.
The recommended duration of treatment with Victrelis may be shorter (24 weeks or 32 weeks), depending on patient and disease characteristics.
But as Victrelis must be taken alongside Roche’s two drugs, NICE calculates that an additional cost of around £11,000 should be added to the overall cost to the NHS, meaning a full course of treatment could cost as much as £41,800.
This is an expensive treatment – but NICE said it still falls well below the £20,000 per QALY gained given its high rate of efficacy, and thus considered it a cost effective option for the NHS.
Meindert Boysen, programme director of technology appraisals at NICE, said: “The significant improvement in sustained virological response rates seen with boceprevir plus peginterferon alfa and ribavirin compared with peginterferon alfa and ribavirin alone represents a major benefit for people with genotype 1 chronic hepatitis C.
“In the past, patients have declined treatment because the perceived chance of a sustained virological response with peginterferon alfa plus ribavirin was too low for them to accept the associated side effects.
“We are therefore very pleased to be able to recommend boceprevir as a cost effective use of NHS resources.”
NICE is also appraising Merck’s rival hep C pill Incivo, which has been developed by Janssen.
Final guidance is set to be published in June, but today’s appraisal for Victrelis could be a good omen for Janssen’s treatment.
Both drugs have impressed in Phase III trials, and have proved that they can clear a higher percentage of the virus in conjunction with Copegus and Pegasus, compared to using these treatments on their own.
Professor Graham Foster, Professor of Hepatology, Barts, said: “The new generation of drugs for patients with genotype 1 hepatitis C have shown very clearly that they can dramatically increase the proportion of patients who are able to clear the viral infection.
“In the first technology appraisal of these drugs, NICE has reviewed the clinical and cost-effectiveness of boceprevir and given a positive recommendation.
“It will now be important to ensure that patients have easy access to the high quality care that they need to give them the best chance of clearing the virus.”
Ben Adams
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