Janssen’s Velcade is not a cost-effective use of NHS resources for the early treatment of multiple myeloma, according to new draft guidance from England’s health guidance body.
The National Institute for Health and Care Excellence (NICE) said that more data from Janssen was needed to justify NHS use of Velcade (bortezomib), when given in combination with dexamethasone and thalidomide to treat patients newly diagnosed with the bone cancer.
The average cost of a course of treatment with Velcade given with dexamethasone is estimated to be around £12,250, while combination treatment with dexamethasone and thalidomide is more than double that at an estimated £24,850.
NICE said the most plausible cost per quality-adjusted life year (QALY) for Velcade, thalidomide and dexamethasone compared with the current standard treatment of cyclophosphamide, thalidomide and dexamethasone was likely to be substantially higher than the £39,000 per QALY compared with thalidomide and dexamethasone.
But the cost effectiveness watchdog drew a blank when it came to the use of Velcade in combination with dexamethasone alone.
Dr Carole Longson, health technology evaluation centre director at NICE, said: “The independent appraisal committee could not assess whether bortezomib in combination with dexamethasone is a cost-effective treatment option because it did not have sufficient information to do so.”
Janssen now has the opportunity to have the draft guidance reversed during a consultation period if it can provide the information NICE is looking for.
A spokesperson for the company told PMLiVE that although Janssen was “disappointed” with the decision it was still “actively participating in this consultation process”.
“We are preparing our response at this time which will include the additional analysis requested by NICE,” the spokesperson concluded.
The drug is already recommended by NICE for use in combination with an alkylating agent and a corticosteroid to treat patients with multiple myeloma who cannot endure high-dose chemotherapy with stem cell transplantation and are unable to receive thalidomide.