Patients living with multiple myeloma across England and Wales should now get ‘routine’ access to Amgen’s Kyprolis on the NHS within three months following a final green light from the National Institute for Health and Care Excellence.

The cost regulator has issued final guidance recommending the drug as an option for patients with relapsed multiple myeloma who have received one prior therapy that does not include bortezomib (Janssen's Velcade).

Kyprolis (carfilzomib) is an intravenously-administered irreversible proteasome inhibitor that binds to the N-terminal threonine site, causing degradation of the proteins in the cell.

Data from the ENDEAVOR study showed that patients treated with Kyprolis/dexamethasone achieved 50 percent greater progression-free survival of 18.7 months compared to 9.4 months in those receiving Janssen's Velcade (bortezomib)/dexamethasone.

The most common adverse reactions (observed in more than 20 percent of patients) include anaemia, fatigue, diarrhoea, thrombocytopenia, nausea, pyrexia, dyspnoea, respiratory tract infection, cough and peripheral oedema.

NICE’s committee concluded that the most plausible incremental cost-effective ratio (ICER) for the drug in combination with dexamethasone in the second-line setting is likely to be £27,629 per quality-adjusted life year (QALY) gained.

The Institute also stressed that its recommendation of Kyprolis is only valid if the company continues to provide a simple, confidential discount to its list price as per the agreed patient access scheme.