New therapies for depression and melanoma have been cleared for National Health Service use in England and Wales by cost regulator the National Institute for Health and Care Excellence.

The Institute is recommending that Lundbeck/Takeda’s Brintellix (vortioxetine) be made available as a third-line treatment for major depressive episodes (MDE), for adults whose condition has responded inadequately to two antidepressants.

Current therapies for MDE have only a 50% success rate due to the diversity of the condition and differing patient profiles, so new treatment options are urgently needed. Brintellix has a multimodal action that targets both inhibition of serotonin reuptake and modulation of serotonin receptor activity.

“As a condition, depression is recurrent, complex and challenging to treat effectively. Providing physicians with a choice of effective and well-tolerated treatments with a range of mechanisms of action is essential to allow patients the best chance of recovery from depression,” noted Allan Young, Chair of Mood Disorders at King's College London.

Elsewhere, Merck, Sharp & Dohme’s immunotherapy Keytruda (pembrolizumab) is recommended as an option for patients with advanced melanoma that has not been previously treated with Bristol-Myers Squibb’s Yervoy (ipilimumab), as long as the company continues to provide with the discount agreed in the patient access scheme.

Otezla rejected

On the downside, the cost regulator is sticking with its decision to reject Celgene’s Otezla (apremilast), because, despite recognising the drug as an innovative step forward in psoriasis treatment, it failed to fall within bounds of what is normally considered value-for-money for the NHS.

Otezla works by reducing the activity of an enzyme called phosphodiesterase known to play a role in the process of inflammation. Unlike current systemic treatments available for psoriasis, it does not require regular lab monitoring, which may help reduce the burden of hospital visits for patients, according to Celgene.

Earlier this year, Mark Goodfield, _Consultant Dermatologist at Leeds Teaching Hospitals NHS Trust, said the drug “has the potential to fill an important gap in the treatment pathway”, and he slammed NICE’s decision, having “seen first-hand the difference this oral treatment can make, particularly in hard to treat areas such as nails and scalp, and for problem symptoms such as itch”.