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Advanced Parkinson’s drug foslevodopa-foscarbidopa approved by NICE

The drug foslevodopa-foscarbidopa (brand name Produodopa) has been recommended in final draft guidance by the National Institute for Health and Care Excellence (NICE) for people with advanced Parkinson’s disease who experience motor fluctuations.

Foslevodopa-foscarbidopa is a solution of carbidopa and levodopa prodrugs for continuous subcutaneous delivery via a portable infusion pump that can be refilled at home by the patient.

As foslevodopa and foscarbidopa are released into the body, foslevodopa is turned into dopamine, which is then used to transmit messages between the parts of the brain and nerves that control movement.

Taking foslevodopa with foscarbidopa increases the availability of foslevodopa in the brain, said NICE.

Oral treatment with levodopa and carbidopa is the standard initial treatment for Parkinson’s, but other treatments may be added as the disease progresses. Non-oral treatments used in advanced Parkinson’s that is responsive to levodopa include apomorphine, deep brain stimulation through surgery or levodopa–carbidopa intestinal gel.

Foslevodopa-foscarbidopa was under consideration by NICE as an alternative to standard oral treatment and levodopa–carbidopa intestinal gel for people who cannot have apomorphine or deep brain stimulation surgery, or for when these treatments no longer control symptoms.

NICE has previously published clinical guidelines and medtech innovation briefings for the condition but this is the first technology appraisal to look at Parkinson’s disease treatments.

Once available on the NHS, foslevodopa-foscarbidopa is set to benefit around 900 patients with advanced Parkinson’s, according to NICE.

Helen Knight, director of medicines evaluation at NICE, said: ’Foslevodopa-foscarbidopa represents an important new treatment for people with advanced Parkinson’s, providing an easy-to-use option that can help them manage their symptoms more reliably and effectively.

’This is the first time NICE has approved a treatment for Parkinson’s and comes after NICE was able to work with [AbbVie] to address the issues that had initially prevented a positive recommendation. We are determined to get the best care to patients fast and ensure value for the taxpayer.’

The charity Parkinson’s UK welcomed the news and said: ’Although Produodopa won’t be suitable for everyone, it is really positive to have another effective treatment for people whose complex movement symptoms are making life difficult.’

It added: ’Now that NICE has approved this life-changing treatment we want to see as many people with Parkinson’s benefit from it. We’ll be encouraging the NHS across England, Northern Ireland and Wales to make sure it’s commissioned. 

’It can take up to three months after NICE approves a treatment for it to be commissioned, so we’ll be monitoring this closely.

’We also want [Produodopa] to be available in Scotland, so we’ll be working with AbbVie and the Scottish Medicines Consortium to make sure that everyone with Parkinson’s can benefit from it.’

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