UK body approves pemextred and infliximab

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The UK’s cost-effectiveness body, the National Institute for Health and Clinical Excellence (NICE), has approved use of pemextred (Alimta®) and infliximab (Remicade®) on the NHS.

NICE has issued final guidance for the use of pemextred to treat malignant pleural mesothelioma (MPM), a cancer associated with asbestos exposure and mostly affecting the lungs, in patients with a World Health Organization performance status of 0 or 1, who are considered to have advanced disease and who are unable to undergo surgery.

Mesothelioma is an aggressive tumour that is often not diagnosed until the advanced stages, at which point patients have an average life expectancy of five months.

Some 1,700 people in the UK are diagnosed with the illness every year, a figure that is likely to peak at more than 2,000 cases by 2015.

Initially, NICE turned down pemextred for MPM, but two subsequent appeals, during which several significant factors came to light �” such as the easy identification of a subgroup of patients in whom the drug has greater effectiveness, and the availability of a smaller 100mg vial to cut costs �” led to a U-turn on the original 2006 decision.

Dr Gillian Leng, deputy chief executive and executive lead for the guidance, commented: “I am confident that we have reached the right conclusion and as a result our guidance will lead to a uniform uptake of this important new treatment for the majority of people with MPM.”

Meanwhile, NICE published final guidance on using infliximab in patients with psoriasis, deeming it an effective use of NHS resources, shortly after allowing the drug for rheumatoid arthritis last October.

Infliximab, which works by blocking tumour necrosis factor, has only been recommended for use in patients with severe forms of the disease who have failed to respond or are intolerant to standard systemic therapies such as ciclosporin or methotrexate.

NICE stipulates that treatment should only be continued in patients showing an adequate response after 10 weeks of therapy.

Professor Peter Littlejohns, NICE clinical and public health director and executive lead for this guidance, said: “We have recommended the use of infliximab for the treatment of adults with psoriasis who will benefit the most.

“This is a good use of NHS resources and it will ensure that patients who suffer from this debilitating and distressing disorder can try an alternative treatment where other therapies have failed.”

NICE