UK's NICE final guidance backs Takeda's Mepact and AstraZeneca's Brilique

The UK’s National Institute for Health and Clinical Excellence (NICE) issued two final guidances this morning, reversing a previous opinion on Japan largest pharma firm Takeda’s Mepact (mifamurtide; The Pharma Letter October 8) and confirming its backing for National Health Service use of Anglo-Swedish drug major AstraZeneca’s (LSE: AZN) blood thinner Brilique/Brilinta (ticagrelor; TPL September 16).

The final NICE guidance recommends the use of Mepact in combination with postoperative multi-agent chemotherapy as an option for treating high-grade resectable non-metastatic osteosarcoma (bone cancer) in children, adolescents and young adults, when it’s made available at a reduced cost to the NHS under a patient access scheme.

The agency said that Takeda submitted a revised patient access scheme (PAS) to the Department of Health, the details of which are confidential as requested by the manufacturer. The new PAS reduced the incremental cost-effectiveness ratio (ICER, which is the extra cost per unit of health gained that the NHS is asked to pay) from £67,000 to £56,000 ($89.314). Having noted the clarification from the NICE Board on how discounting is applied, this resulted in a further reduction in the ICER to £36,000, at which point the Committee recommended mifamurtide.