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NHS England approves AbbVie’s Duodopa for Parkinson’s disease

Published on 06/07/15 at 10:12am

AbbVie has been handed a boost by NHS England, who has approved the prescribing of its Parkinson’s disease treatment Duodopa through a new commissioning policy.

For the first time, NHS England has backed doctors to prescribe Duodopa (levodopa-carbidopa intestinal gel) to suitable people with advanced Parkinson’s disease, through its specialised commissioning prioritisation process.

This process prioritises drugs and treatments that NHS England will fund at specialist centres only, and follows a three-month public consultation on the principles and processes NHS England will follow when making investment decisions.

Some 23 of 39 drugs and treatments have been approved, including new treatments – Janssen’s Sirturo (bedaquiline) and Otsuka’s Deltyba (delamanid) – for drug-resistant tuberculosis, and Roche’s Rituximab (mabthera) for kidney conditions in children and people with acquired haemophilia.

Duodopa has only been available on the NHS in England as an intestinal gel over the last eight years through an individual funding request (IFR) for each patient, which critics said often created a time-consuming administrative burden and led to postcode lotteries in access to the treatment. It is given directly through the intestine and may be prescribed for some people with Parkinson’s who have tried other combinations of medicines but do not have satisfactory control of their symptoms.

Matt Regan, UK general manager at AbbVie says: “Patients have been waiting a long time for this decision, it’s very positive news for people living with Parkinson’s. There should now be consistent access to this medicine and we urge the NHS to ensure the policy is implemented quickly and smoothly.”

Professor K Ray Chaudhuri, consultant neurologist and professor in neurology and movement disorders at the Kings College Hospital Parkinson's centre of excellence in London, says the policy “represents a positive step forward in the management of Parkinson’s”.

He adds: “To date, access to Duodopa has been highly variable and severely restricted, in spite of its wide availability in most European countries. Clinicians, patients and their carers can now realistically consider this as a treatment option when Parkinson’s symptoms advance and become unmanageable by other therapies. There is a real need to offer people further treatment options at the advanced stage.”

James Palmer, NHS England’s clinical director for specialised commissioning, says: “These are really difficult decisions, which is why we rely on NICE wherever possible, and make use of the best available evidence as well as extensive engagement with clinical experts, patient representatives and the public. The new policies we have been able to approve will help us to improve and extend thousands of lives for years to come through prevention, identification and treatment.”

However Palmer has admitted that the NHS will struggle to afford new and innovative treatments, partly due to ongoing funding pressures within the health service, and partly because of a failure to reallocate funds from the PPRS agreement.

Despite the ABPI and the Department of Health confirming a payment of £207 million from pharma to underwrite growth of the medicines bill for the first quarter of 2015, Palmer told an audience of pharma industry insiders at the IMS Health Market Access summit in London that specialised services did not “get back any money… to spend on new products” and that the funds “went back into the Department of Health…. for baseline commissioning.”

He told delegates: “I think the chances of specialised services having a significant growth allocation of money, to deal with the 11 per cent growth at least in drugs, is not going to happen. We can’t afford everything, and there will be drugs and treatments that we can’t afford.”

Lilian Anekwe

The full list of specialised services approved by NHS England is available here.

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