Generic clopidogrel helps NICE recommend blood clot prevention
pharmafile | August 5, 2010 | News story | Sales and Marketing | NICE, Plavix
NICE has given preliminary approval for wider use of Sanofi-Aventis’s Plavix and Boehringer Ingelheim’s Persantine to prevent blood clots.
It recommends anti-clotting agent clopidogrel as an option for people who have had an ischaemic stroke (brain clots lasting for more than 24 hours).
The recent launch of generic versions of Sanofi’s drug has helped bring the price of the drug down, which NICE says made its use more compelling.
Clopidogrel is also indicated for patients that have peripheral arterial disease – a narrowing in the arteries of the arms of legs – in more than one vascular site, a condition that makes them more susceptible to stroke or heart attacks.
- This wider indication of clopidogrel is only recommended with the least costly license preparation and only for patients who have had a heart attack if aspirin is contraindicated or not tolerated.
- Boehringer Ingelheim’s Persantine (dipyridamole) plus aspirin has been recommended for patients who have had a transient ischaemic stroke (brain clots that last for less than 24 hours) only where treatment with aspirin and Plavix is contraindicated or not tolerated.
- Modified-release Persantine alone as an option for patients who have had a clot-related stroke is recommended only where treatment with aspirin or Plavix is contraindicated or not tolerated.
The updated guidance aims to prevent recurrent blood clots, a ‘silent killer’ in the UK and globally, using a wider range of antiplatelet agents. The launch of generic versions of clopidogrel across Europe will also see lower prices of the drug, meaning it is more cost-effective for the NHS.
Professor Peter Littlejohns, clinical and public health director at NICE, said: “We know that heart attacks and strokes are some of the biggest killers and causes of disability in England and Wales and that people who have had one heart attack or stroke are at a greater risk of having another.”
Since the original NICE guidance was published in 2005, there have been two further studies that have looked at the use of clopidogrel and modified-release dipyridamole plus aspirin for the prevention of occlusive vascular events.
Littlejohns commented: “Both were supportive of the conclusions in that guidance. Further, the availability of clopidogrel as a generic preparation has seen a marked fall in its price and this has meant that the Committee has been able to recommend that it now be used more widely. There is also evidence that the drugs continue to provide benefit beyond the two years previously suggested by the original guidance and this is reflected in the draft guidance published today.”
The appraisal consultation document can be found here until 25 August 2010.
Ben Adams
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