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NICE recommends BMS-Pfizer's Eliquis after fast-track appraisal

Final draft guidance backs Bristol-Myers Squibb and Pfizer's anticoagulant to prevent venous thromboembolism in adults

The UK's National Institute for Health and Clinical Excellence (NICE) has recommended the use of Eliquis (apixaban) for the prevention of blood clots in patients after surgery.

The Institute produced its final draft guidance after a fast-track appraisal of Bristol-Myers Squibb and Pfizer's drug and backed Eliquis' use in England and Wales for the prevention of venous thromboembolism (VTE) in adults who have undergone planned total hip replacement or total knee replacement surgery.

Professor Carole Longson, NICE Health Technology Evaluation Centre director, explained: “People having this type of surgery are at risk of venous thromboembolism because of the nature of the trauma caused during surgery and because they need to remain inactive for a period of time after their operation.”

The final draft guidance from NICE recommending  Eliquis comes just six months after it received its European VTE prevention licence.

Current NICE guidance recommends that people having elective hip replacement or elective knee replacement surgery should be offered current anticoagulant treatments heparin, dabigatran etexilate, rivaroxaban or fondaparinux to prevent VTE, which encompasses the blood clotting conditions deep vein thrombosis and pulmonary embolism, with patients at particular risk of developing VTE increasing following surgical procedures.

Studies so far have only compared Eliquis to enoxaparin, however, Longson said that the NICE's appraisal committee was satisfied that Eliquis is a clinically and cost effective option for preventing blood clots, alongside other effective treatments already recommended by the regulatory body.

The cost of Eliquis treatment is estimated to be £41.16 (based on 12 days' treatment) for knee replacement surgery and £116.62 for hip replacement surgery (based on 34 days' treatment).

Eliquis has also been filed for approval in the EU for the prevention of stroke in atrial fibrillation (AF) patients. Study results have been positive so far in this indication, with the ARISTOTLE trial demonstrating a 21 per cent reduced risk of stroke or systemic embolism for patients taking Eliquis compared to standard treatment warfarin.

29th November 2011


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