Batch of mixed NICE decisions for Xarelto, Imnovid, Jardiance and Targaxan

The National Institute of Health and Care Excellence (NICE), the medicines cost watchdog for England and Wales, today announced several National Health Service funding decisions.

First up, in final guidance published the NICE has recommended German pharma major Bayer’s (BAYN: DE) Xarelto (rivaroxaban), in combination with clopidogrel and aspirin, or with aspirin alone, as an option for preventing blood clots in people who have had an acute coronary syndrome.

Carole Longson, director of the NICE Centre for Health Technology Evaluation, commented: “Based on the evidence considered, the independent Appraisal Committee concluded that rivaroxaban, in combination with aspirin plus clopidogrel or with aspirin alone, was more effective than aspirin plus clopidogrel or aspirin alone for preventing further cardiovascular deaths and heart attacks in people with acute coronary syndrome and raised cardiac biomarkers. The Committee therefore recommended rivaroxaban as a cost-effective use of NHS resources.”

She continued: “Because rivaroxaban is associated with a higher risk of causing bleeding than clopidogrel in combination with aspirin or aspirin alone, the guidance recommends that before starting treatment doctors should carry out a careful assessment of a person’s bleeding risk. The decision to start treatment should be made after an informed discussion between the doctor and patient about the benefits and risks of rivaroxaban. Also, because there is limited experience of treatment with rivaroxaban up to 24 months, the guidance recommends careful consideration should be given to whether treatment is continued beyond 12 months.”