Roche’s Ocrevus has now won NICE backing as a treatment for relapsing–remitting multiple sclerosis in adults, having first been turned down by the cost watchdog.
NHS funding for the drug is being endorsed when alemtuzumab is contraindicated or otherwise unsuitable, and the company provides Ocrevus (ocrelizumab) at the discounted price agreed in the confidential patient access scheme.
The Institute says clinical trial results show that it reduces relapses and slows the progression of disability compared with interferon beta-1a for people with relapsing-remitting MS.
An indirect comparison shows that the drug is more effective in reducing relapses than other treatments used at this stage (interferon beta-1b, glatiramer acetate, dimethyl fumarate, fingolimod and teriflunomide), and as effective as alemtuzumab and natalizumab.
But whether Ocrevus slows the rate at which the disease worsens in some people compared with these other treatments remains uncertain, NICE stressed.
The committee concluded that the most plausible cost-effectiveness estimates for Ocrevus fell within the range considered to be value for money for the NHS, but only when provided at the discount agreed with Roche. “However, it is more costly and no more effective than alemtuzumab,” it noted.
Around 100,000 people in the UK live with MS, and 85 percent have a relapsing-remitting form eligible for treatment with Ocrevus.
Ocrevus was approved in Europe in January this year for the treatment of both relapsing forms of multiple sclerosis and early primary progressive multiple sclerosis (PPMS), for which there is no other disease-modifying treatment currently available.
The drug is a humanised monoclonal antibody designed to selectively target CD20-positive B cells, a specific type of immune cell thought to be a key contributor to myelin and axonal (nerve cell) damage, which can lead to disability in people with MS.
“There is significant unmet need in the treatment of MS, particularly for those with PPMS who currently have no disease-modifying treatment options. We welcome this positive NICE review for RRMS, and hope that it brings us closer to the treatment being made available to people with early PPMS too,” said Jo Sopala, director of development at the MS Trust.
Roche said it is committed to working with NICE to ensure people with early PPMS are also able to access the drug through the NHS.