Cost regulators are backing the expanded use of Boehringer Ingelheim’s clot buster Pradaxa (dabigatran) by the National Health Service in England.

The National Institute for Health and Care Excellence has this morning published draft guidelines endorsing the drug to both treat and prevent recurrent and potentially fatal blood clots in the legs and lungs.

People with suspected deep vein thrombosis or pulmonary embolism are generally treated immediately with bloodthinners, most commonly with injections of low molecular weight heparin, and when the diagnosis is confirmed this is then overlapped with an oral anticoagulant such as warfarin.

But using warfarin can present difficulties for patients; the drug is associated with a high bleeding risk and so patients must to be monitored on a frequent basis to ensure that the blood is clotting properly.

The Institute noted that while the most plausible incremental cost effectiveness ratio for Pradaxa for compared with warfarin for acute treatment was uncertain, both the company’s and the Expert Review Group’s estimates fell within the value for money range, i.e. under £20,000 per QALY gained.  

For combined treatment and secondary prevention, the Committee considered that ICER for Pradaxa versus warfarin was likely fall somewhere between the company’s estimate of £9,973 per QALY gained and the ERG’s figure of £35,786 per QALY gained.

NICE has previously approved funding for the use of Pradaxa on the NHS in England to prevent venous thrombembolic events in adults who have undergone elective total hip or total knee replacement surgery, and for the prevention of stroke and systemic embolism in people with atrial fibrillation (AF).

Patients in Scotland are already getting access to the drug in the venous thromboembolism setting after the Scottish Medicines Consortium gave its blessing earlier this month.