Vidaza too costly for NICE
pharmafile | March 8, 2010 | News story | Sales and Marketing | Celgene, NICE, Vidaza
NICE has rejected Celgene’s Vidaza for use on the NHS to treat the rare bone marrow disease myelodysplastic syndrome.
The Institute ruled Vidaza (azacitidine) was not cost-effective – calculating that making it available to the general patient population would cost £63,000 per quality-adjusted life year (QALY) gained.
Vidaza was also not recommended for patients with forms of chronic myelomonocytic leukaemia or acute myeloid leukaemia.
NICE was not swayed by a patient access scheme Celgene had agreed with the Department of Health to reduce the cost of the drug to the NHS.
NICE’s Health Technology Evaluation Centre director Dr Carole Longson said: “Azacitidine is the first drug that has been developed specifically for treating MDS. It is not a cure, but could potentially prolong the life of people with these conditions by around nine months longer than standard treatment.
“We are disappointed not to be able to recommend this drug. The independent Appraisal Committee considered all published evidence on the effectiveness azacitidine and the cost, including the proposed ‘patient access scheme’.
“The Appraisal Committee concluded that relative to the benefits, the price the NHS is being asked to pay for azacitidine, is still too high for it to be recommended as a cost effective use of NHS resources.”
There are currently 700 patients in England and Wales with myelodysplastic syndrome (MDS) and most have to rely on frequent blood transfusions to manage the anaemia and extreme fatigue associated with their condition.
A group of eight patient groups joined together to express their disappointment at the decision.
Macmillan Cancer Support, Leukaemia CARE, Leukaemia & Lymphoma Research, The CML Support Group UK, Rare Disease UK, UK MDS Forum and the Myelodysplastic Syndromes Foundation are backing a petition that calls on the prime minister to ensure MDS patients receive care comparable with that available in most other European countries.
David Hall, chairman of the MDS UK Patient Support Group and an MDS patient, said: “This is a huge blow to MDS patients, particularly those with the high risk forms of these diseases for whom the outlook is often bleak.
“Azacitidine is the only licensed drug available specifically to treat MDS and has been proven not only to slow the progress of the disease but also vastly improve patients’ quality of life by freeing them from repeated cycles of blood transfusions.”
He also questioned NICE’s calculations, saying that low patient numbers meant any financial savings would be negligible.
NICE’s decision comes one month after it warned the pharma industry on the necessity of cost-effectiveness.
Earlier this year draft guidance for Bristol Myers-Squibb’s Sprycel (dasatinib) and Novartis’ Tasigna (nilotinib) for chronic myeloid leukaemia and a preliminary appraisal of Novartis’ Afinitor (everolimus) in advanced renal cell carcinoma deemed all three not cost-effective.
Commenting at the time NICE clinical and public health director Professor Peter Littlejohns said: “It would be heartening to hear that the pharmaceutical company manufacturers are prepared to share some of the very high cost of the drugs with the NHS.”
More recently Zeltia’s Yondelis (trabectedin), indicated for the treatment of rare soft tissue cancers, was given the thumbs up by NICE but only after the manufacturer agreed to meet the cost for anyone needing more than five cycles of treatment.
The health service faces strong pressure to keep a lid on costs. Last November the government told NHS trusts they would have to deliver efficiency savings of £15-20 billion over the three years from 2011 to 2014.
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