In Final Draft Guidance NICE Rejects Celgene’s Multiple Myeloma Drug

England’s cost-regulator issued a final draft guidance rejecting Celgene’s next generation multiple myeloma drug, due to its high cost.

In the National Institute for Health and Care Excellence (NICE) final draft guidance, it recommended against use of Celgene’s Imnovid (pomalidomide) for treatment of patients with multiple myeloma, a type of cancer that affects plasma cells, which are white blood cells found in the bone marrow.

The cost-regulator said that the drug, in combination with dexamethasone, is not recommended within its marketing authorization for treating relapsed and refractory multiple myeloma in adults who had at least two prior treatments, including lenalidomide and bortezomib, and whose disease has progressed on the last therapy. NICE said that Imnovid does not offer enough benefit to justify its high price.

NICE recommends thalidomide for most patients as a first line treatment, and bortezomib for people who are unable to take thalidomide and also as an option after the first treatment has stopped working. NICE recommends lenalidomide for people who have received two prior treatments. The regulator does not recommend Imnovid until after third or subsequent relapse.

NICE has been known to reject sever new cancer drugs. A recent analysis found that cancer drugs were 56 percent more likely to be rejected by NICE than drugs not intended for cancer patients, which were rejected only 16 percent of the time.

“NICE has already recommended a number of treatment options for multiple myeloma – thalidomide, bortezomib and lenalidomide – which can greatly improve the length of time someone can live with the disease and their quality of life. Unfortunately we cannot recommend pomalidomide as the analyses from Celgene, the company that markets pomalidomide, showed that the drug does not offer enough benefit to justify its high price,” said Sir Andrew Dillon, NICE chief executive.

Now, the draft guidance is in the hands of consultees, who have the option to appeal against it. Until a final guidance is issued, NHS bodies should make decisions locally on the funding of the drug.

Source: National Institute for Health and Care Excellence

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