NICE says no to Celgene myeloma drug Imnovid

NICE has issued final guidance not recommending Celgene’s multiple myeloma treatment Imnovid (pomalidomide).

Imnovid was approved in August 2013 for treating patients with multiple myeloma in combination with dexamethasone after two previous treatments including lenalidomide (Celgene’s Revlimid) and bortezomib (Janssen’s Velcade), and whose disease has progressed in the last therapy.

The decision confirms a ruling NICE made in November. NICE’s appraisal committee says it was persuaded that the drug extends life for at least three months on average when compared with standard NHS care, but that it cost effectiveness was not proved.

Celgene’s submission put the cost per QALY gained at over £50,000 compared with Velcade. The figure was even higher – more than £70,000 per QALY – when compared with bendamustine plus thalidomide and dexamethasone, putting it well above the range normally considered to be cost effective.

NICE has recommended Celgene’s own Thalidomide, Janssen’s Velcade (bortezomib) and Celgene’s Revlimid – which can slow the progress of the condition and help relieve symptoms. NICE says these drugs have greatly improved the length of time someone can live with the disease and their quality of life.

Commenting on the guidance, Sir Andrew Dillon, NICE chief executive, said: “Unfortunately we cannot recommend pomalidomide as the analyses from Celgene, the company that markets the drug, showed that it does not offer enough benefit to justify its high price.”

Cancer Drugs Fund

Despite NICE’s negative ruling, Imnovid remains on England’s Cancer Drugs Fund, surviving a de-listing of drugs in January.

However five blood cancer drugs were de-listed across eight separate indications, the changes coming into effect this month. Experts in the field drew particular attention to the de-listing of Janssen’s Velcade (bortezomib) for patients with mantle cell lymphoma, Waldenstrom’s macroglobulinaemia and multiple myeloma who relapse after previous treatment with the drug.

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