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NICE makes a U-turn and approves ocrelizumab for relapsing remitting MS patients

The National Institute for Health Care and Excellence (NICE) has approved ocrelizumab (Ocrevus) as a treatment option for people with active relapsing remitting multiple sclerosis (RRMS). 

Back in April this year, NICE turned down ocrelizumab as an option for RRMS patients claiming it wasn’t cost effective. At the time it made it clear in its consultation that it wasn’t sure the ‘costly drug’ had a place with the others currently available.

But after a review of its decision, NICE is now recommending the drug as an option for adults with active RRMS, defined by clinical or imaging features. However, there are some conditions to adhere to. In order to qualify these patients can only be treated with ocrelizumab if alemtuzumab is contraindicated or otherwise unsuitable. These conditions were set because although NICE has secured an undisclosed discounted rate for the drug it is still more costly than alemtuzumab. Ocrelizumab costs £4,790 per 300 mg vial. 

Current NHS treatments for RRMS include alemtuzumab, beta interferons, cladribine, dimethyl fumarate, fingolimod, glatiramer acetate, natalizumab and teriflunomide. 

Clinical trial results show that ocrelizumab reduces the number of relapses and slows disability progression compared with interferon beta-1a for people with RRMS. 

Indirect analyses suggest that ocrelizumab reduces the number of relapses compared with interferon beta-1b, glatiramer acetate, dimethyl fumarate, fingolimod and teriflunomide, and is as effective as alemtuzumab and natalizumab. These analyses suggest that ocrelizumab slows disease progression in the total RRMS population compared with some treatments but not others. 

NICE stressed that this recommendation will not 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: 25/06/18

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