Celgene’s Thalidomide and Janssen-Cilag’s Velcade have been recommended as options to treat patients with multiple myeloma on the National Health Service by its cost regulator.

The National Institute for Health and Clinical Excellence has published draft guidance backing use of the drugs in England and Wales after a review found them to be a cost effective use of NHS resources in treating the disease, a type of cancer that develops from cells in the bone marrow.

Specifically, the cost watchdog has recommended a combination of Thalidomide, an alkylating agent and a corticosteroid for first-line treatment of multiple myeloma for people who cannot take high-dose chemotherapy with stem cell transplantation.

Velcade (bortezomib) in combination with an alkylating agent and a corticosteroid is being endorsed as a treatment option when the patient is unable to tolerate or has contraindications to thalidomide, the Institute said.

Around 3,600 cases of multiple myeloma are diagnosed in the UK every year and, according to NICE’s appraisal committee, evidence from clinical specialists indicated that a thalidomide regimen would be considered most appropriate in the majority of cases.

Furthermore, while the clinical effectiveness of the two regimens seems equivalent, thalidomide regimens are generally cheaper than Velcade-based ones - £2,100 per treatment cycle versus £3,000, respectively - explaining the Committee’s choice of Celgene’s drug as the first port of call.

The evidence “clearly showed that both thalidomide and bortezomib regimens are more effective at delaying disease progression and improving patients’ life expectancy than the current treatment of an alkylating agent and corticosteroid alone,” and the Institute is pleased to be able to provisionally recommend these treatments for patients with the disease, said Carole Longson, Health Technology Evaluation Centre Director at NICE.

But Janssen-Cilag said it plans to appeal the draft guidance as a large proportion of myeloma patients would be denied the chance of treatment with Velcade if the recommendations were to go live.

“We believe we have demonstrated that bortezomib is a clinically and cost-effective treatment option for this group of newly diagnosed myeloma patients. For this reason we intent to appeal the draft recommendation which would mean that cancer patients in England and Wales would be disadvantaged compared t those in much of Europe, where bortezomib has been widely available in this setting for a number of years,” the group said.