NICE opens NHS door to blood cancer (Multiple Myeloma) therapy Revlimid

The Institute has published a final appraisal determination document endorsing the use of Revlimid (lenalidomide) in combination with dexamethasone on the National Health Service to treat patients with the blood cancer who have received at least two prior therapies.

The move marks a complete u-turn on the Institute’s previous position on the drug, which it originally rejected for multiple myeloma in the autumn of last year because it claimed it was not a cost-effective use of NHS resources, sparking outcry from charities and patients.

At the time, NICE clinical and public health director Peter Littlejohns said that should Revlimid – which has a price tag of around £4,368 per month of therapy - be given the thumbs-up, “other patients would lose out on treatments that are both clinically and cost effective”.

However, following the extension of the cost-effectiveness threshold for ‘end-of-life drugs’ earlier this year, as well as a newly proposed cost-sharing scheme by Celgene, the Institute changed track and has now added the drug be to the NHS’ treatment menu in the England and Wales.

Under Celgene’s proposed patient access scheme, which has been accepted by the Department of Health, the NHS will cover the cost of Revlimid for up to 26 cycles of treatment, lasting about two years, after which the drugmaker will pick up the tab for any further therapy, therefore minimising the financial burden on the health service.

Breakthrough therapy
Revlimid is widely considered to be a breakthrough oral drug and, according to the firm, clinical trials have clearly demonstrated its ability to significantly extend survival and time to disease progression, so news of the its inclusion on the NHS will be welcomed by patients and healthcare professionals alike.

Commenting on the FAD, Gareth Morgan, Professor of Haematology at Royal Marsden NHS Foundation Trust, said that while multiple myeloma is still an incurable blood cancer, “new therapies like Revlimid are offering significant extensions of survival for patients and moving the disease toward becoming a chronic, manageable condition,” and that its endorsement by NICE is “a major step toward providing a critical new option for patients in the UK”.

And Eric Low, Chief Executive of Myeloma UK, said the NHS approval of Revlimid is “a great win” for patients, and he stressed it is now “critically important that Primary Care Trusts implement this guidance immediately”.

By Selina McKee