UK’s NICE draft guidance recommends Lilly’s Efient

UK health care watchdog the National Institute for Health and Care Excellence (NICE) has today published updated draft guidance recommending National Health Service use of US pharma major Eli Lilly’s (NYSE: LLY) Efient (prasugrel) in combination with aspirin for preventing blood clots in people who have had a heart attack or who have unstable angina (collectively called acute coronary syndromes) and who are also having a procedure to widen narrowed arteries in the heart (percutaneous coronary intervention).

Prasugrel belongs to a class of drugs called anti-platelets. These work by reducing or preventing the formation of blood clots, so that blood flow to the heart muscle can be maintained to prevent further damage.

“This review assessed the clinical and cost effectiveness of prasugrel, noting that since the original guidance was published in 2009 NICE has also published guidance on the use of ticagrelor for the same indication, and the price of another drug, clopidogrel, has reduced as generic versions have become available. Taking these factors into consideration, the draft guidance now recommends prasugrel as an option for more people with acute coronary syndromes than our previous guidance,” commented Carole Langson, director of the Centre for Health Technology Evaluation at NICE.

Could be advantageous for STEMI patients

She continued: “The [Appraisal] Committee also heard from clinical experts that the faster action of prasugrel compared to clopidogrel could be an advantage for [ST-segment-elevation myocardial infarction] STEMI patients who need immediate percutaneous coronary intervention. The draft guidance also recommends prasugrel as an option for people with NSTEMI and unstable angina, with or without diabetes. For people with diabetes, who have a greater risk of cardiovascular events during and after percutaneous coronary intervention, the evidence shows that prasugrel was more effective in reducing the rate of non-fatal heart attack, non-fatal stroke or death from cardiovascular causes compared with clopidogrel.”