UK Cost Watchdog Recommends Two Drugs, but Rejects a Third

The National Institute for Health and Care Excellence yesterday recommended that the National Health Service cover drugs for acute coronary syndrome and type 2 diabetes, but turned down one for multiple myeloma.

At $8,385 a year, the cost of Bayer’s heart drug Xarelto (rivaroxaban) alongside aspirin or Bristol-Myers Squibb’s Plavix (clopidogrel) — or in combination with both — is well below NICE’s $29,000 to $45,000 threshold for drugs subsidized by the NHS. Adjusting that figure for any intentional bias is also unlikely to increase the drug’s cost significantly, NICE says.

Due to the significant risk of bleeding associated with Xarelto, however, physicians and patients should think carefully the drug’s benefits before starting treatment — and again after 12 months, the guidance says.

NICE reversed itself on Boehringer Ingelheim’s Jardiance (empagliflozin), recommending that the diabetes drug be used in combination with metformin alone, with metformin and a sulfonylurea or thiazolidinedione, or with insulin and other antidiabetic drugs.

Last summer, NICE asked the company to submit additional data comparing the incremental cost-effectiveness ratios of Jardiance with drugs with sodium glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors.

Meanwhile, NICE determined that Celgene’s Imnovid (pomalidomide) is too costly to add to the already sufficient list of multiple myeloma therapies. According to the guidance, the drugmaker failed to demonstrate that its drug would be more cost-effective than existing therapies, especially at $75,000 a year.

NICE final guidance is binding. Read the documents at www.fdanews.com/03-25-15-rivaroxaban.pdf, www.fdanews.com/03-25-15-empagliflozin.pdf and www.fdanews.com/03-25-15-pomalidomide.pdf. — Lena Freund