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Discount convinces NICE to uphold recommendation for Novartis’ Xolair

Asthma drug now also available for children

NICE Novartis Xolair

The National Institute for Health and Clinical Excellence (NICE) has backed down on draft guidance to withdraw its recommendation for Novartis’ Xolair in the treatment of asthma. 

The cost-effectiveness body for England and Wales said in November 2012 that, in the light of new evidence following changes to the drug’s dosing schedule, it was no longer able to recommend Xolair (omalizumab) for severe persistent allergic asthma in adults – overturning its initial recommendation in 2007.

However, Novartis has now offered Xolair at a discount through a patient access scheme, convincing NICE to release final draft guidance upholding the 2007 recommendation.

In a boon for Novartis, the latest recommendation also covers adolescents and children aged six years and over with severe, persistent allergic asthma, opening up a new market for the drug in England and Wales.

Both recommendations cover Xolair’s use as an add-on therapy for people whose asthma remains poorly controlled despite receiving optimised standard therapy, such as high-dose inhaled corticosteroids.

Professor Carole Longson, Health Technology Evaluation Centre director at NICE, explained the “significant effect” asthma can have on an individual.

She said: “We are therefore pleased to now be able to recommend omalizumab as an effective therapy for adults, adolescents and children with this condition in final draft guidance, with the discount agreed in the patient access scheme submitted by the manufacturer."

This undisclosed discount means Novartis will cover part of the price of Xolair, which can cost between £1,665 per patient per year to £26,640 per patient per year, depending on the severity of the condition and the dosage used by patients.

With the discount, Xolair has an incremental cost effectiveness ratio (ICER) of £23,200 per quality adjusted life year (QALY), falling beneath NICE’s upper limit of about £30,000.

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