NICE extends recommendation for Efient
pharmafile | July 24, 2014 | News story | Sales and Marketing | ACS, Efient, NICE, Plavix, longs ton, prasugrel
In updated guidance NICE has extended its recommendation of Efient (prasugrel) in combination with aspirin for preventing blood clots in people with acute coronary syndromes (ACS) or who are having a procedure to widen narrowed arteries in the heart.
The once-daily, oral antiplatelet was previously used as an option for preventing atherothrombotic events only when immediate primary percutaneous intervention for ST-segment-elevation myocardial infarction (STEMI) was necessary.
That guidance has now been widened to be available for preventing atherothrombotic events for adults with ACS with unstable angina or non-ST-segment elevation myocardial infarction (NSTEMI) having percutaneous coronary intervention (PCI).
The new recommendation comes as Efient is now regarded as a cost-effective option when compared to generic Plavix (clopidogrel).
Professor Carole Longson, director of the centre for health technology evaluation at NICE says: “This review assessed the clinical and cost-effectiveness of prasugrel, noting that since the original guidance was published in 2009 NICE has also published guidance on the use of ticagrelor for the same indication, and the price of another drug, clopidogrel, has reduced as generic versions have become available.
“The Committee also heard from clinical experts that the faster action of prasugrel compared to clopidogrel could be an advantage for STEMI patients who need immediate percutaneous coronary intervention. The guidance also recommends prasugrel as an option for people with NSTEMI and unstable angina, with or without diabetes.”
Efient belongs to a class of drugs called anti-platelets. These work by reducing or preventing the formation of blood clots, so that blood flow to the heart can be maintained to prevent further damage.
Its annual costs will be £628.48 (excluding VAT) – though costs may of course vary due to negotiated procurement discounts.
In England it is estimated there are approximately 82,000 myocardial infarctions every year. Of the 80,974 hospital admissions with a final diagnosis of myocardial infarction recorded in the Myocardial Ischaemia National Audit Project (MINAP), 40% were STEMIs and 60% were NSTEMIs.
Tim Kinnaird, consultant cardiologist at University College Cardiff, who acted as an adviser to the NICE appraisal committee says that the recommendation is ‘very welcome’, adding: “Having another cost-effective option for unstable angina and NSTEMI patients undergoing PCI is particularly relevant to the UK, as this patient population is generally treated poorly compared to STEMI patients undergoing PCI.”
Emily MacKenzie
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