UK's NICE backs use of TMC's Angiox for STEMI patients undergoing primary PCI

Following a previous positive draft guidance, the UK drugs watch dog the National Institute for Health and Clinical Excellence today has now recommended National Health Service use of USA-based The Medicines Company’s (Nasdaq: MDCO) Angiox (bivalirudin), in combination with aspirin and clopidogrel for the treatment of adults with ST-segment-elevation myocardial infarction (STEMI or heart attack) undergoing emergency lifesaving procedures to unblock their coronary arteries (primary Percutaneous Coronary Intervention or PCI; The Pharma Letter June 20).

The basis of this recommendation was a review of clinical and cost efficacy data comparing the bivalirudin strategy against a regimen of heparin with glycoprotein inhibitor in combination with aspirin and clopidogrel. Primary care Trusts in England and Wales will now be encouraged to adopt the bivalirudin strategy for STEMI patients undergoing primary PCI.

In its review the NICE’s Appraisal Committee noted “the robustness of the clinical data, in which treatment with bivalirudin dominated treatment with a glycoprotein IIb/IIIa inhibitor plus heparin (that is, was less costly and more effective) and that the results of the model are robust to the various sensitivity analyses.” The Committee concluded that “the model is associated with a very low degree of decision uncertainty and that bivalirudin should be recommended for the treatment of adults with STEMI undergoing PCI.”