A limited number of patients with atrial fibrillation could soon get routine access to Sanofi-Aventis’ Multaq (dronedarone) on the National Health Service, after the cost watchdog recommended the drug under certain conditions.

The National Institute for Health and Clinical Excellence initially turned down the drug for use on the NHS because it was considered too expensive to be a cost-effective use of resources, but on the back of comments received during the consultation period it has now revised its original recommendations.

The latest draft guidance says doctors can prescribe Multaq but only as a second-line treatment in people with additional cardiovascular risk factors whose AF is not adequately under control.

The drug’s limited use recommendation came after the Appraisal Committee conceded that, while dronedarone may not as effective as other anti-arrhythmic therapies currently in use, it does offer the benefit of not increasing the risk of mortality, unlike the anti-arrhythmics with which it was compared, and is likely to result in fewer adverse effects than the gold-standard treatment amiodarone.

According to the Atrial Fibrillation Association, studies have demonstrated that Multaq - the first new anti-arrhythmic drug launched in the last decade - is able to cut the incidence of AF “to a level at least equal to that of current anti-arrhythmic drugs available” but with “far fewer side effects than commonly experienced by patients prescribed currently available drugs”, and that its use could lead to a reduction in hospitalisation and stroke.

“Whilst dronedarone has not been shown to be as effective as existing treatment options in controlling atrial fibrillation, and is more expensive, short term evidence suggests that it is associated with fewer side-effects,” agreed the Institute’s chief executive Andrew Dillion. “Therefore we are pleased that, following public consultation on the first draft of this guidance, we have been able to identify circumstances in which dronedarone could be offered as a cost effective treatment option,” he said.

Fellows and scholars
Meanwhile, the Institute unveiled yesterday which healthcare professionals have been awarded its first ever fellowships and scholarships, and said Lord Ara Darzi, Chair of Surgery at Imperial College London and former Health Minister, has also been appointed as the Institute’s first honorary NICE Fellow.

Twenty awards have been presented to a wide variety of NHS health professionals, including those in general practice, public health and intensive care, all chosen for “their dedication, foresight and experience in promoting clinically- and cost-effective practice in the NHS,” said Professor Peter Littlejohns, Director of Clinical and Public Health at NICE.

“While the fellowships and scholarships will provide them with opportunities to develop further in their own careers and improve the quality of healthcare in their local areas, we also hope that they will allow us to engage even more closely with the NHS and foster a growing network of individuals who are committed to promoting our core values,” he explained.