Otezla gets another No from NICE

[Fred]

Following on from the report about Otezla getting refused by NICE (National Institute for Heath and Care Excellence) for psoriatic arthritis NICE says no to Otezla for psoriatic arthritis they have also now confirmed it will not be used for psoriasis.

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NICE does not recommend apremilast (also called Otezla and manufactured by Celgene) for treating adults with moderate to severe chronic plaque psoriasis.

People whose treatment with apremilast was funded by the NHS before this guidance was published should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

Source: nice.org.uk

[jiml]

Is this purely on cost they have rejected it ?

The price of apremilast is £265.18 for a 14-day treatment initiation pack (4×10 mg tablet; 4×20 mg tablet; 19×30 mg tablet) and £550.00 for a 28-day-treatment standard pack (56×30 mg) (excluding VAT; ‘Monthly Index of Medical Specialities’ [MIMS] online accessed March 2015). The cost of 12 months of treatment with apremilast is estimated at £7140.18 (company submission). Costs may vary in different settings because of negotiated procurement discounts.

That doesn't sound expensive to me I'm sure other drugs cost more, and Otezla has had some success. I don't understand why it's not being approved

[Fred]

They haven't said yet Jim as far as I know but to quote the reason for a no for psoriatic arthritis I would say the reason is much the same.

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compared with TNF-alpha inhibitors, apremilast was the least clinically effective for treating psoriatic arthritis although some costs were saved by its use. Importantly, there was not enough robust evidence demonstrating that apremilast slows progression of the disease compared to TNF-alpha inhibitors.

[jiml]

They haven't said yet Jim as far as I know but to quote the reason for a no for psoriatic arthritis I would say the reason is much the same.

Quote:

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compared with TNF-alpha inhibitors, apremilast was the least clinically effective for treating psoriatic arthritis although some costs were saved by its use. Importantly, there was not enough robust evidence demonstrating that apremilast slows progression of the disease compared to TNF-alpha inhibitors.

Again I'll say what I said before there's no way to get robust evidence without having it out there being used ,

[Fred]

They haven't said yet Jim as far as I know but to quote the reason for a no for psoriatic arthritis I would say the reason is much the same.

Quote:

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compared with TNF-alpha inhibitors, apremilast was the least clinically effective for treating psoriatic arthritis although some costs were saved by its use. Importantly, there was not enough robust evidence demonstrating that apremilast slows progression of the disease compared to TNF-alpha inhibitors.

Again I'll say what I said before there's no way to get robust evidence without having it out there being used ,

True but they have to weigh up the costs to the NHS against the effectiveness of the treatment by what evidence they have. As you know there are a lot of treatments in the pipeline and what I have read on Otezla so far it's not looking good, so they are better off spending their money on something like your oral treatment Fumaderm  which already has a good track record.

[Grizzly Bear]

NICE, I take it none of these overpaid twats have psoriasis

Get rid of them and the savings of their extortionate pay and expenses would fund otezla

[mataribot]

Otezla works well psorasis. Doesn't do much for arthritis. I would say this is mostly politics.