More NHS patients in the UK are set to have access to Bayer’s oral anticoagulant Xarelto after it was recommended for use to prevent blood clots in people who have had a heart attack.
The National Institute for Heath and Care Excellence (NICE), which provides NHS guidelines for England and Wales, issued draft guidance saying the Xarelto (rivaroxaban) was a cost-effective use of NHS resources for secondary prevention in acute coronary syndrome (ACS).
ACS is a range of serious conditions, including heart attack, that is caused by blood flow in the coronary arteries and results in over 114,000 hospital admissions each year.
The Xarelto recommendation, which is now up for consultation before a final decision is made, covers patients who have ACS severe enough to result in the release of biomarkers into the blood that show heart muscle has been damaged.
Xarelto is one of a new generation of oral anticoagulants launched in the past few years that prevent clots forming in blood vessels and can be used to treat and prevent a variety of conditions.
Specifically, Xarelto stops a substance called Factor Xa from working. Factor Xa is necessary in the formation of thrombin and fibrin, key components in the formation of blood clots.
The new ACS guidance recommends Xarelto in combination with aspirin plus the antiplatelet medicine clopidogrel or with aspirin alone after studies demonstrated this regimen was more effective than aspirin plus clopidogrel or aspirin alone.
Since its launch the drug has emerged as one of Bayer’s leading products, reaching sales of more than $2bn for 2013, according to PMLiVE’s Top Pharma List.
This has been helped by its wide range of blood clot indications, several of which NICE has previously recommended. These include the treatment and prevention of deep vein thrombosis and pulmonary embolism, the prevention of stroke in people with atrial fibrillation and the prevention of venous thromboembolism after total hip or total knee replacement in adults.
The new draft guidance allows Bayer to retain an edge over rival anticoagulants from Boehringer Ingelheim and Bristol-Myers Squibb/Pfizer, whose own respective oral medicines Pradaxa (dabigatran etexilate) and Eliquis (apixaban) are yet to be approved in an ACS indication in Europe.