atients with the rare blood cancer multiple myeloma have been granted access to a new treatment option after the National Institute for Health and Clinical Excellence published final guidance this morning endorsing the use of Celgene’s Revlimid on the National Health Service.

The cost watchdog for England and Wales has recommended the drug in combination with the chemotherapy dexamethasone for use in patients with multiple myeloma who have had at least two prior therapies.

But the path into the NHS has not been a smooth one for Revlimid (lenalidomide), which the Institute initially rejected because the drug – with a price tag of around £4,368 per month of therapy - was considered too expensive.

However, a risk-sharing scheme proposed by Celgene under which it pays for any treatment beyond 26 cycles of the drug, coupled with new advice on approving so-called end-of-life drugs, helped persuade NICE’s advisory committee that the therapy could indeed offer a cost-effective use of NHS resources.

Clinical benefits
On the clinical side, Revlimid is widely considered to be a breakthrough oral drug and clinical trials have demonstrated its power in extending survival and time to disease progression, and so news of its inclusion on the NHS’ treatment list will be welcomed by patients and healthcare professionals alike.

“NICE already recommended Velcade (bortezomib) in October 2007 under a risk sharing scheme for patients who are experiencing their first relapse and publication of this new NICE guidance is good news for patients who have already tried other chemotherapy regimens,” commented Professor Peter Littlejohns, Clinical and Public Health Director at NICE.

Understandably Celgene says it is “pleased” with the decision, which its regional vice-president, Northern Europe, adds is also “a welcome recognition of the value of oral medicines like, Revlimid, which allow patients to take their treatments at home freeing up healthcare resources.”