atients in the UK with multiple myeloma were given a new ray of hope last week, after the National Institute for Health and Clinical Excellence changed its position on the use of Celgene’s Revlimid on the National Health Service.

In the autumn of last year, the Institute sparked outcry from charities and patients with its recommendation to reject the use of Revlimid (lenalidomide), in combination with dexamethasone, for patients with the blood cancer MM because it was not deemed a cost-effective use of NHS resources.

At the time, NICE clinical and public health director Peter Littlejohns said that should the drug – which has a price tag of around £4,368 per month of therapy - be given the thumbs-up, “other patients would lose out on treatments that are both clinically and cost effective”.

But following the extension of the cost-effectiveness threshold for ‘end-of-life drugs’ earlier this year, as well as a newly proposed cost-sharing scheme by Celgene, the Institute has now changed track and is recommending the drug be added to the NHS’ treatment menu in the England and Wales.

Celgene is understandably pleased with the news. “This recommendation from NICE is a welcome recognition of the increasing value innovative medicines provide to patients and healthcare systems,” commented Sol J. Barer, Chairman and Chief Executive Officer of the group. “In particular, Revlimid offers patients a convenient, long-term, continuous therapy that suppresses their disease and enables them to live longer, more productive lives,” he added.

Sharing the bill
Under the new pricing scheme, the NHS will pay for treatment with Revlimid for the first two years in patients who have received at least one prior therapy, but should treatment be required after this time then the drugmaker will cover any costs, thereby reducing the financial burden on the health service.

Revlimid is considered to be a breakthrough oral drug that extends the lives of myeloma patients by up to three years, and Eric Low, Chief Executive of Myeloma UK says the new draft guidance, which is open for public consultation until February 20, represents “a great win for myeloma patients and a good example of all stakeholders taking responsibility, overcoming barriers and finding a workable solution.”

The new cost-sharing agreement follows the creation of the first risk-sharing partnership between NICE and a pharma company back in 2007, in the form of a money-back scheme under which the NHS funds the treatment of MM patients showing a full or partial response to Millennium Pharmaceuticals and Janssen Cilag’s Velcade (bortezomib), while the costs incurred for those not responding are refunded by the drugmakers.