Cystic fibrosis patients in England and Wales will now have access to two new drugs from Novartis and Forest Laboratories to treat lung infections.
Both the Tobi Podhaler (tobramycin) from Novartis and Colobreathe (colistimethate sodium) received backing to treat people with cystic fibrosis who have chronic pulmonary infection caused by Pseudomonas aeruginosa in final guidance published by the National Institute for Health and Clinical Excellence (NICE).
However, both recommendations only further a limited group of patients, and both Forest and Novartis will have to provide their drugs at a discount through a patient access scheme.
The limited recommendation takes into account that the Tobi Podhaler and Colobreathe are dry powder versions of already available nebulised products.
As such, NICE has said that Colobreathe should only be used in cystic fibrosis patients who would clinically benefit from continued colistimethate sodium but do not tolerate it in its nebulised form.
The Tobi Podhaler should only be used in cystic fibrosis patients for whom nebulised tobramycin is considered an appropriate treatment. This comprises patients unable to take nebulised colistimethate sodium as it is contraindicated, not tolerated or has not produced an adequate response.
This leaves nebulised colistimethate sodium as the first choice for people with cystic fibrosis who contract chronic pulmonary infection caused by Pseudomonas aeruginosa. If this therapy proves unsuitable, doctors will have to consider the patient’s circumstances before deciding what is the best alternative therapy.
Both drugs are available at a similar price, with the Tobi Podhaler costing £1,760 for 56 days of treatment, while Colobreathe is priced at £1,936 for 56 days of treatment.
The NHS will only pay a certain amount of the cost, however, due to the drug’s respective patient access schemes. Details of both these schemes are confidential.
Cystic fibrosis affects around 8,000 people in the UK, and respiratory failure resulting from chronic pulmonary infection caused by Pseudomonas aeruginosa is the main cause of death of people with the condition.