Treatment deemed too costly to treat primary progressive MS
The NHS will not fund treatment with Roche’s recently-approved multiple sclerosis drug Ocrevus, even though it is the only treatment for the primary progressive form of the disease.
The final appraisal document from the National Institute for Health and Care Excellence (NICE) has caused consternation among patients – and an immediate petition from the MS Society – for Roche, NHS England and NICE to reach an agreement that will allow the drug to be covered for PPMS.
Ocrevus (ocrelizumab) is currently available on the NHS in England and Wales to treat people with relapsing-remitting forms of the disease (RRMS) on the NHS, but NICE says the drug costs too much and, while trial results show that it can slow the worsening of disability in people with the condition, “the size and duration of this effect are uncertain”.
Roche has offered an undisclosed discount on the £4,790 per 300mg vial list price for Ocrevus – which is administered as two 300mg infusions two weeks apart followed by a single 600mg infusion every six months – but is being hamstring by the fact that Ocrevus is already available for RRMS at its full price.
“Roche [has] offered a lower price, but NICE are not allowed to accept a different price from what they pay for it to treat relapsing MS,” notes the MS Society, which says the drugmaker has called for NICE to be allowed to consider this dual-pricing approach.
Ocrevus became the first and only drug to be approved in the EU for PPMS in January on the strength of the ORATORIO study which showed it slowed disability progression by around 24% in PPMS patients. At the same time It got the green light for RRMS, where there are multiple treatment options including beta interferons, Teva’s Copaxone (glatiramer acetate) and generics, and new oral therapies such as Novartis’ Gilenya (fingolimod) and Biogen’s Tecfidera (dimethyl fumarate).
Richard Erwin, general manager of Roche UK, said NICE’s decision was “devastating news for people with PPMS who urgently deserve access to the first and only licensed treatment which has been proven to slow the progression of this highly-disabling disease.”
He added: “the committee has recognized ocrelizumab as an innovative treatment that provides a step change in the treatment of PPMS with a substantial effect on the lives of patients and their families. “We ask that NICE are given the flexibility to consider an indication-specific price for ocrelizumab in PPMS.”