The National Institute for Health and Clinical Excellence is backing the use of Bristol-Myers Squibb/Otsuka’s Ability for the treatment of schizophrenia in 15-17 year olds on the National Health Service.

However, the cost watchdog has stipulated that Abilify (aripiprazole) should only be considered an option in patients who cannot take or are unresponsive to treatment with Johnson & Johnson’s Risperdal (risperidone), which is currently the most widely used first-line antipsychotic treatment for this age group in the UK.

“Although aripiprazole was not found to be as cost effective as risperidone as a first-line treatment, the Committee felt that people who were unable to take risperidone may benefit from aripiprazole being available as a treatment option,” said Carole Longson, Health Technology Evaluation Centre Director at NICE, explaining the decision.

The recommendation for Abilify follows an earlier request by the Institute for additional evidence on the drug’s clinical and cost effectiveness compared with other schizophrenia drugs on the market, including Risperdal, Eli Lilly’s Zyprexa (olanzapine), AstraZeneca’s Seroquel (quetiapine) and Novartis’ Clozaril (clozapine).

The manufacturer’s updated base-case analysis showed that treatment sequences in which Abilify is used first result in an incremental cost ranging from £52,750 per QALY (quality adjusted life year) gained to £108,800 per QALY gained when compared with treatment regimens in which Risperdal is used first, prompting NICE to recommend the drug only when treatment with J&J’s drug is not an option.