Patients in England and Wales who have suffered a certain type of heart attack will likely get access to The Medicines Company's Angiox on the National Health Service according to final draft guidance by cost regulators.

The National Institute for Health and Clinical Excellence is backing the use of Angiox (bivalirudin) in patients who have suffered a an ST-segment-elevation myocardial infarction, or ‘STEMI’, deeming its use cost-effective when used alongside aspirin and clopidogrel in those undergoing primary percutaneous coronary intervention (PCI).

STEMI heart attacks occur when the cholesterol-rich deposits along artery walls rip, freeing up blood clots that then block the arteries and consequently cause damage to the heart muscle. 

Current treatment strategies aim to reopen the arteries blocked by these deposits, through medication to dissolve them and PCI, a surgical procedure involving the insertion of wires, balloons or stents into the arteries to open them up and bust the clot.

Angiox is an anticoagulant medicine given during PCI to thin the blood and prevent it from clotting, and according to NICE's appraisal committee, evidence shows that the drug is both more effective and less expensive than treatment with the commonly-used combination of heparin and a glycoprotein inhibitor.

Drug benefits

"As well as reducing the risk of dying following PCI, the committee noted that the use of bivalirudin was associated with a lower incidence of major bleeding events compared with heparin and glycoprotein inhibitors," explained Carole Longson, NICE Health Technology Evaluation Centre Director.

Because of the strength of the evidence in support of Angiox' use on the NHS, NICE noted that it was "deemed appropriate" to move straight to the final stage of guidance development, in order to help patients get quicker access to the treatment, providing no objections are raised during the consultation.