SMC decides Celgene's Imnovid is not cost-effective

People in Scotland with the blood cancer multiple myeloma should not have access to Celgene's Imnovid at its current price, according to the Scottish Medicines Consortirum (SMC).

The decision was published in the latest round-up of decisions from the SMC, which provides guidance on medicines for use with NHS Scotland. Drugs that received backing included Sanofi's Lemtrada for multiple sclerosis (MS), a subcutaneous formulation of Roche's Mabthera and AstraZeneca's Forxiga for type 2 diabetes.

The same could not be said for Imnovid (pomalidomide), which is approved in Europe in combination with dexamethasone for the treatment of adult patients with relapsed and refractory multiple myeloma who have received at least two prior treatment regimens.

In its statement, the SMC acknowledged that Imnovid plus dexamethasone “significantly increased progression-free survival compared with high-dose dexamethasone” in this group of patients, but it also said data presented by Celgene did not justify the treatment's cost in relation to its benefit.

Dr Adrian Kilcoyne, medical director at Celgene UK & Ireland, said: “We are obviously disappointed with today's decision especially since the SMC acknowledged that pomalidomide substantially improved the life expectancy of patients with relapsed and refractory multiple myeloma.

“We will of course do everything we can to try and ensure that patients in Scotland are able to access the treatment and have therefore already re-entered into discussions with the SMC,” he added.

SMC recommendations

There was positive news for other patients, however, as the SMC recommended several other new treatments.

These included Lemtrada (alemtuzumab), an MS treatment developed by Genzyme, part of Sanofi. The SMC recommended the drug's use for the relapsing remitting form of MS based on studies where Lemtrada demonstrated a statistically significant relative decrease in relapse rate compared to current treatment Rebif (interferon beta 1a).

The SMC also recommended UCB's Cimzia in patients with active psoriatic arthritis, although its use is restricted to adults who have inadequate response to treatment with a disease-modifying antirheumatic drug (DMARD).

AZ's Forxiga was recommended at the second attempt for use in adults with type 2 diabetes as an add-on combination therapy while it was also good news for Roche, which had a subcutaneous version of Mabthera (rituximab) recommended for use in certain patients with non-Hodgkin's lymphoma.

There was also a positive decision on Allergan's Botox (botulinum toxin type A) for use in the management of bladder dysfunctions.