The National Institute for Health and Care Excellence has rejected AstraZeneca's Daxas for use by the NHS to treat certain patients with chronic obstructive pulmonary disease (COPD).

Draft guidelines do not recommend the drug as an add-on to bronchodilator treatment for severe forms of the disease in adults with chronic bronchitis and frequent exacerbations.

Daxas (roflumilast) is an orally administered long-acting selective phosphodiesterase-4 enzyme inhibitor that targets cells and mediators believed to play a key role in COPD.

AZ' base case ICER (incremental cost effectiveness ration) was calculated to be £18,774 per QALY gained, but the Committee felt that the figure was more likely to be around £71,365 per QALY based on different data sets, and thus substantially above the range normally considered a cost-effective use of NHS resources.

AZ picked up full ownership of the drug in May last year when it completed its acquisition of Takeda's core respiratory business in a deal worth $575 million.