Patients with multiple myeloma will not be able to access Celgene’s Imnovid (pomalidomide) on the National Health Service in England after cost-regulators issued a final draft ‘no’ for funding as a third-line treatment.

The National Institute for Health and Care Excellence is sticking with its stance that the drug fails to offer enough benefit to justify its price, and notes that there are already several options available to patients with the condition to slow disease progression and improve quality of life.

NICE currently recommends thalidomide for most patients in the first instance, Velcade (bortezomib) for people unable to take thalidomide and as a second-line option, and Revlimid (lenalidomide) for patients who have already received two prior therapies. 

All cost per QALY (Quality Adjusted Life Year) figures presented by Celgene exceeded £50,000 compared with Velcade, and £70,000 versus bendamustine plus thalidomide and dexamethasone, and would further increase when a number “of more realistic assumptions” were included in the model, NICE said.

However, across the border, following a resubmission the Scottish Medicines Consortium has now endorsed the drug for use on NHS Scotland, while patients in England can still able to access treatment with Imnovid through the Cancer Drugs Fund after it was saved from the chop last month.

Celgene disappointed

Adrian Kilcoyne, medical director at Celgene UK & Ireland, said “we are clearly disappointed by NICE’s decision…as we provided the health technology body with the best evidence available for an oral treatment for relapsed and refractory multiple myeloma that can be taken at home and has been shown both to extend life and also improve the quality of life”.
 
He added that “we are in discussions with NICE and the Department of Health and are hopeful that we can find an appropriate solution that enables patients to continue to be able to access pomalidomide in the long term”. In the meantime, patients in England can still access Imnovid via the Cancer Drugs Fund “although this option is unfortunately not yet available to patients living in Wales”.