The National Institute for Health and Care Excellence has published draft guidelines rejecting NHS funding for Shire’s Revestive as a treatment for short bowel syndrome (SBS).

SBS is a chronic condition relating to a reduced ability to absorb nutrients in the intestine. Patients need intravenous nutrition through a catheter that lasts for many hours across several days of the week, which can cause complications such as catheter-related infections.

Revestive (teduglutide) is a glucagon-like peptide-2 (GLP-2) analogue licensed for treating patients in a stable condition after their intestine has adapted post-surgery. The drug is designed to improve the absorption of nutrients and fluid from the remaining gastrointestinal tract and enhances key structural and functional adaptations in the intestinal mucosa.

NICE’s appraisal committee found that the drug reduces, but does not remove, the need for intravenous nutrition.

However, its incremental cost-effectiveness ratio was caluculated to be around £193,549 per quality-adjusted life year (QALY) gained in adults, and thus well outside of the bounds of what is normally considered an acceptable use of NHS resources.