NICE yes for Revlimid after price limit

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NICE has recommended Celgene's Revlimid (lenalidomide) as an option for treating myelodysplastic syndromes.

The institute has reversed its opinion of the drug in its final draft guidance after Celgene provided further evidence to support its cost effectiveness, as well as offering a discount via a patient access scheme (PAS).

Myelodysplastic syndromes (MDS), which are diagnosed in around 2000 people each year in England, are a group of bone marrow disorders characterised by the underproduction of one or more types of blood cells due to dysfunction of the marrow. MDS can lead to life threatening disease including acute myeloid leukaemia (AML), as well as anaemia and increased risk of bleeding and infections.

This appraisal focused on the use of lenalidomide for treating people with a specific type of MDS that is characterised by a chromosomal abnormality called an isolated deletion 5q cytogenetic abnormality. Currently the main treatment option for people with this type of MDS considered is best supportive care including regular blood transfusions.

Commenting on the final draft guidance, Sir Andrew Dillon, NICE chief executive, said: "The committee heard from clinical experts that lenalidomide is an effective therapy. Celgene – who market lenalidomide – worked with us to provide enough evidence to make it possible for us to recommend it for this group of people.

"Celgene provided a revised analyses and further information on their proposal for a reduction in the cost of the drug to the NHS (patient access scheme)."

Celgene's patient access scheme involves the NHS paying for lenalidomide treatment for up to 26 monthly cycles. The company will provide the drug free of charge for those people who receive more than 26 monthly cycles.

The draft guidance is now with consultees, who have the opportunity to appeal against it. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.

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Andrew McConaghie

20 August, 2014