GlaxoSmithKline gets negative NICE appraisal for Revolade; another attack on safety of Avandia

Just a day after GlaxoSmithKline received a refusal to fund National Health Service use of its breast cancer drug Tyverb (lapatinib; The Pharma Letter June 10), the UK's National Institute for Health and Clinical Excellence (NICE), in a preliminary guidance, has said it cannot recommend another of its drugs, Revolade (eltrombopag), for treating chronic immune (idiopathic) thrombocytopenic purpura (ITP), a rare blood clotting disorder in splenectomized adults who do not respond to other treatments (for example, corticosteroids, immunoglobulins or as second-line treatment for non-splenectomized adults when surgery is not advised.

The independent Appraisal Committee considered the use of eltrombopag in two groups of people - those who do and those who do not have persistent bleeding problems. The committee concluded that, although eltrombopag can raise platelet levels, the evidence was very unclear about how many health benefits eltrombopag would provide compared with other existing treatments. The cost of eltrombopag in relation to the estimated health benefits was also far greater than what is normally considered a cost effective use of NHS resources.

Annual treatment cost of £22,020-£33,030