On the same day that two cancer drugs were recommended for NHS use in England and Wales, the National Institute for Health and Care Excellence (NICE) backed new treatment options for constipation and blood clot.
NICE, which provides healthcare recommendations to the NHS, issued new guidance on the use of Sucampo Pharma Europe’s Amitiza (lubiprostone) for adults with chronic idiopathic constipation and updated its view on Lilly’s Efient (prasugrel) to include people with acute coronary syndromes.
The Amitiza recommendation follows earlier draft guidance published in June that determined the drug was a cost effective treatment option for certain patients who have constipation of an unknown cause.
As with this guideline, NICE said the drug should be made available to patients who have failed at least two previous laxatives at maximum tolerated doses for a period of six months, and for whom invasive procedures are being considered.
The treatment comes at a cost of £53.48 for a pack of 56 capsules or £29.68 for the 28 capsule pack.
“Chronic idiopathic constipation can be very distressing,” said Prof Carole Longson, director of NICE”s health technology evaluation centre. “Symptoms go beyond difficulty going to the lavatory and can be embarrassing for the person affected. It is a painful condition and those who suffer from it can experience a decreased quality of life.”
Now that the final guidance has been published the NHS has a legal duty to begin funding the treatment for eligible patients within the next three months.
New Efient guidance
NICE also updated the guidance for blood clot prevention drug Efient to include a wider reach of patients.
Lilly’s drug is now recommended in combination with aspirin for the prevention of blood clots in people who have had a heart attack or who have unstable angina, two conditions that come under the term acute coronary syndromes. The new guidance also covers the drug’s use in people who are having a procedure to widen narrowed arteries in the heart.
This expands Efient’s use beyond its 2009 recommendation for use in combination with aspirin as an option for preventing atherothrombotic events in people with acute coronary syndromes who have percutaneous coronary intervention and when certain other conditions are met.
NICE’s Prof Longson said the guidance was updated because a similar therapy ticagrelor had been recommendation in the same indication and because the price of clopidogrel had reduced due to the availability of generics.
“Taking these factors into consideration, we are now recommending prasugrel as an option for more people with acute coronary syndromes than our previous guidance,” said Prof Longson.