Hours after turning down the company’s breast cancer drug Tyverb, the National Institute for Health and Clinical Excellence has ruled against GlaxoSmithKline’s clotting disorder treatment Revolade for funding on the National Health Service.

In preliminary guidance published this morning, NICE says that Revolade (eltrombopag) is not recommended for treating chronic immune thrombocytopenic purpura (ITP) in splenectomised adults who do not respond to other treatments, for example corticosteroids and immunoglobulins, or as second-line treatment for non-splenectomised adults when surgery is not advised.

The UK cost regulator says an independent appraisal committee considered the use of eltrombopag in two groups of people - those who do and those who do not have persistent bleeding problems. It concluded that, although the drug can raise platelet levels, “the evidence was very unclear about how many health benefits eltrombopag would provide compared with other existing treatments”.

NICE added that the cost of Revolade “in relation to the estimated health benefits was also far greater than what is normally considered a cost effective use of NHS resources”. Revolade has an average cost of £55 for each 50mg tablet, resulting in an annual price from £22,020-£33,030.

The agency’s deputy chief executive Gillian Leng said the committee “understood that for people living with ITP, the risk of bleeding can have a considerable effect on their daily activities and also prevent or delay surgery…but unfortunately, the committee felt there was not sufficient evidence to recommend eltrombopag as a treatment for ITP”.

The recommendation is preliminary and GSK says it will respond before final guidance is published in October 2010. In adults, ITP occurs in about six in 100,000 people; it is more common in women and predominantly occurs in those of child bearing age.