UK – After discount row, NICE finally says yes to first line Revlimid

England catches up with rest of Europe. NICE has recommended Celgene’s Revlimid as a first line treatment in transplant ineligible multiple myeloma patients – a full four years after its European approval.

While Revlimid has become the ‘backbone treatment’ for multiple myeloma patients in most developed countries, it has been used only as a third line treatment on the NHS, until now.

Since it gained an EU licence in first line use back in 2015, the drug’s appraisal by NICE has been held up by disagreements about the patient access scheme (PAS), or discount scheme applied to the drug.

The drug’s list price in England is up to £4,368 a month, or over £52,400 a year per patient, with the confidential PAS discount cutting this substantially.

NHS England last year called for NICE’s appraisal to be halted so that it could address concerns about Celgene’s existing PAS – which was both complex and failed to return savings made by hospitals to its central budget.

The scale of this expenditure is what has driven cost-conscious NHS England to seek a better deal, and reflects its growing control of secondary care drug budgets and market access…