Certain patients with myelodysplastic syndromes have gained access to Celgene’s Revlimid (lenalidomide) after cost-regulators approved funding for its use on the National Health Service in England.
The National Institute for Health and Care Excellence (NICE) has today published final guidance endorsing Revlimid for the treatment of a specific type of MDS characterised by a chromosomal mutation called an isolated deletion 5q cytogenetic abnormality.
Currently, the main approach for this kind of MDS is best supportive care, including regular blood transfusions, so having a specific treatment option will no doubt be welcome news for patients.
But Revlimid’s availability on the NHS was a close call. NICE was initially minded to rejected the drug because it was not convinced that it actually extended lives, but was swayed when Celgene provided further evidence in support, as well as a patient access scheme (PAS) under which it foots the bill for treatment beyond 26 cycles.
A 28-day cycle with Revlimid 10mg (excluding VAT) costs £3,780. The company’s base-case incremental cost-effectiveness ratio (ICER) for lenalidomide compared with best supportive care with the PAS was calculated to be £25,300 per QALY gained. But, the Committee stressed that because the proportion of people on treatment beyond 26 cycles was uncertain, so were the potential cost savings from PAS.
MDS are a group of bone marrow disorders characterised by the underproduction of one or more types of blood cells, diagnosed in around 2,000 people every year in England.