NICE says no to BMS for second-line Orencia
pharmafile | August 25, 2011 | News story | Sales and Marketing | BMS, NICE, Orencia, rheumatoid arthritis
In final draft guidance NICE has not recommended the use of Bristol-Myers Squibb’s arthritis drug Orencia after other drugs have failed.
NICE has previously issued a positive recommendation the NHS to use Orencia (abatacept) as a second line treatment in patients with rheumatoid arthritis after tumour necrosis factor drugs – such as J&J’s Remicade – have failed.
But in this new guidance, it is not recommending the drug, in combination with methotrexate, for patients whose disease has responded inadequately to one or more conventional non-biological disease modifying anti-rheumatic drugs (DMARDs).
Professor Carole Longson, health technology evaluation centre director at NICE, said: “NICE has previously issued a positive recommendation for the use of Orencia in certain circumstances, to help people with rheumatoid arthritis. “However, the evidence considered by the appraisal committee did not support using [the drug] as a second line treatment option.”
Longson said the decision was made the easier for NICE as Bristol-Myers Squibb itself admitted the drug would not be cost-effective in this setting when compared to current NICE-recommended treatments.
These include Abbott’s Humira (adalimumab), Pfizer’s Enbrel (etanercept), J&J’s Remicade (infliximab), and Merck’s Simponi (golimumab), which are all available for second line use after other drugs have failed.
BMS did, however, believe that its drug could be compared with Remicade, the only other intravenous treatment option, because of its method of administration.
But NICE did not consider this to be a relevant comparison, since route of administration “rarely determines which drug to prescribe”, according to the watchdog.
This is because devices used to inject at home have improved significantly, and few people now experience problems handling the injection devices, NICE said.
Both the dose and cost of Orencia depends on body weight – for a typical patient weighing 60 – 100 kg, the cost is £10,171.14 in the first year, and £9444.63 in subsequent years, although costs may vary in different settings however because of negotiated discounts.
BMS, which made $733 million from the all of the drug’s indications last year, did not appeal the decision.
Ben Adams
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