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NICE decisions made on Bayer, Celgene and Boehringer drugs

Published on 26/03/15 at 08:34am
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In final guidance NICE has recommended Bayer’s Xarelto and Boehringer’s Jardiance for NHS funding, but not Celgene’s Imnovid.

Bayer’s Xarelto (rivaroxaban) has been shown the green light in combination with clopidogrel and aspirin – or with aspirin alone – as an option for preventing blood clots in people who have had a heart attack. 

Bayer’s Xarelto is licensed for patients who have an attack severe enough to result in the release of cardiac biomarkers into the blood that show heart muscle has been damaged. It is given along with aspirin and clopidogrel – another drug that helps to prevent the blood from clotting – or with aspirin alone. 

Given as a tablet Xarelto stops a substance called Factor Xa from working, and Factor Xa is necessary in the formation of thrombin and fibrin, the key components in blood clot formation.

Professor Carole Longson, NICE Health Technology Evaluation Centre director, says: “Based on the evidence considered, the independent appraisal committee concluded that rivaroxaban, in combination with aspirin plus clopidogrel or with aspirin alone, was more effective than aspirin plus clopidogrel or aspirin alone for preventing further cardiovascular deaths and heart attacks in people with acute coronary syndrome and raised cardiac biomarkers. The committee therefore recommended rivaroxaban as a cost-effective use of NHS resources.

The UK watchdog has not got such good news for Swiss firm Celgene however, as its final guidance regarding NHS funding has seen it turn down Imnovid (pomalidomide) for treating multiple myeloma.

This type of cancer affects plasma cells which are white blood cells found in the bone marrow, and although it is incurable, there are a number of treatment options to help slow the progress of the disease and improve quality of life NICE says.

Namely thalidomide, bortezomib and lenalidomide the healthcare body notes – which can improve the length of time someone can live with the disease and their quality of life. Its appraisal considered the use of Imnovid for treating multiple myeloma after third or subsequent relapse.

Commenting on the guidance NICE chief executive Sir Andrew Dillon says: “Unfortunately we cannot recommend pomalidomide as the analyses from Celgene, the company that markets the drug, showed that it does not offer enough benefit to justify its high price.

On the receiving end of a more positive decision was Boehringer with its Jardiance (empagliflozin) which NICE has now recommended to treat type 2 diabetes.

This follows an optimistic determination earlier in the year when the German manufacturer submitted a new cost-effectiveness model showing that its Jardiance combination therapy is viable.

Jardiance provides an additional option for people with type 2 diabetes alongside other treatments that have similar costs and outcomes, and belongs to a class of drugs called sodium glucose co-transporter (SGLT-2) inhibitors which work by blocking re-absorption of blood sugar by the kidneys, in turn reducing the amount of sugar in the blood.

The NHS now has a legal obligation to begin funding this treatment for eligible patients within the next 3 months. Lilly and Boehringer’s combo diabetes drug Glyxambi – which contains Jardiance – is now available to treat adult patients in the US it was announced yesterday.

Brett Wells

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