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NICE claims ocrelizumab is not cost effective for the treatment of primary progressive MS

The Department of Health and Social Care has asked the National Institute for Health and Care Excellence (NICE) to produce guidance on using ocrelizumab (Ocrevus) for treating primary progressive multiple sclerosis (PPMS) in the NHS in England. Currently ocrelizumab is not recommended for the treatment of early PPMS because it is not cost effective for NHS use.

There are currently no disease modifying treatments approved for PPMS. Clinical trial results show that ocrelizumab can slow the worsening of disability in patients, including the loss of upper limb function. 

However, NICE’s claims: ‘the most plausible cost-effectiveness estimate for ocrelizumab compared with best supportive care alone are much higher than those NICE normally considers an acceptable use of NHS resources’. And this is why the drug cannot currently be recommended for the treatments of early PPMS in adults.

The drug will now go through a consultation process and the appraisal committee are interested in receiving comments on the following: 

  • Has all of the relevant evidence been taken into account? 
  • Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence? 
  • Are the recommendations sound and a suitable basis for guidance to the NHS?
  • Are there any aspects of the recommendations that need particular consideration to ensure we avoid unlawful discrimination against any group of people on the grounds of race, gender, disability, religion or belief, sexual orientation, age, gender reassignment, pregnancy and maternity?

This guidance is not final and the answers to these questions could help change the end decision, but the MS community needs to speak up and share their thoughts. To provide feedback visit the NICE website and create an account. The closing date for feedback is the 19 July 2018.

NICE specified that this recommendation is not intended to affect treatment with ocrelizumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop. 

Source: MS-UK

Date: 29/06/18

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