Draft guidance from NICE recommends Bayer's Xarelto for PE and DVT

UK drugs watchdog the National Institute for Health and Care Excellence (NICE) this morning (April 19) issued final draft guidance recommending German drugmaker Bayer’s (BAYN: DE) Xarelto (rivaroxaban) as a clinically and cost-effective option for treating pulmonary embolism (PE) and preventing recurrent deep vein thrombosis (DVT) and PE after acute PE in adults. The draft guidance has been issued to consultees for appeal and published on the NICE web site for information.

Carole Longson, the NICE’s Health Technology Evaluation Centre Director, said: “The Committee heard from the patient expert that the regular monitoring and dose adjustment needed with warfarin, which needs regular visits to hospital or GP appointments, can be costly and inconvenient, and means some people might have to take time off work. Also, because warfarin has many drug interactions, it may be unsuitable for people with co-morbidities. In addition, the Committee heard that warfarin has various food interactions which often require people to adjust and monitor their diet and lifestyle. Rivaroxaban therefore represents a significant potential benefit for people with PE and DVT because it avoids the need for initiation with heparin and the subsequent transition to warfarin.”

For lifelong treatment, the NICE Appraisal Committee concluded that the most plausible Incremental Cost Effectiveness Ratio (ICER) for lifelong treatment was between £17,900 and £22,900 per QALY gained. The Committee concluded that rivaroxaban is a cost-effective treatment option for the lifelong treatment of pulmonary embolism and prevention of recurrent thromboembolism for people in whom long-term treatment is indicated. Rivaroxaban costs £2.10 per 15mg or 20mg tablet. The cost of treatment is estimated to be £235.86, £427.61 and £811.13 for three, six and 12 months of treatment respectively.