Sanofi-Aventis’ Multaq is just a short hop away from winning the final seal of approval for use on the National Health Service, after cost regulators recommended its use in certain patients with atrial fibrillation.

The National Institute for Health and Clinical Excellence has reconfirmed its decision to endorse the drug’s use, albeit limited, on the NHS, but only as a second-line treatment in patients with additional cardiovascular risk factors – such as high blood pressure - whose AF has not been handled by first-line therapy.

The Institute initially turned down the Multaq (dronedarone) because it was considered too expensive to be a cost-effective use of resources, particularly as it may not be as effective as other anti-arrhythmic therapies currently in use, but on the back of comments received during the consultation period revised its original recommendations.

Both patients and experts stressed that, while Multaq may not be as effective as its peers in preventing the recurrent of AF, it seems to be associated with fewer side effects and, importantly, also a lower risk of mortality compared with other current anti-arrhythmic drugs.

However, given the high rates of the condition, with more than 46,000 new cases of AF each year, as well as the drug’s relatively high price - £2.25 per day compared to £0.05 per day for comparator drug amiodarone - the cost watchdog has capped its use on the NHS to secure better value for money.