Relapsing-remitting multiple sclerosis (RRMS) patients with active disease may now be treated with Ocrevus (ocrelizumab, developed by Genentech) within the National Health Service (NHS) — the subsidized public health system that covers England and Wales. But those in Scotland will not.
The National Institute for Health and Care Excellence, known as NICE, recommended that Ocrevus be included among the treatments provided RRMS patients in the two countries it covers. Eligible patients are those experiencing relapses or with brain imaging evidence (on an MRI) of new areas of disease activity, and who are unable or unwilling to be treated with Lemtrada (alemtuzumab, Sanofi Genzyme). A decision regarding primary progressive MS (PPMS) patients is awaited.
This decision reverses an earlier finding by NICE that Ocrevus did not meet its “value for money” standard for inclusion in the public health system for England and Wales. Genentech, which is part of the Roche group, worked with the agency to reach agreement on an undisclosed price for the infusion treatment, which sells in the U.S. at an estimated annual list price of $65,000.
But in Scotland, the SMC (Scottish Medicines Consortium) found that Genentech did not “present a sufficiently robust economic assessment” of Ocrevus’ cost-effectiveness relative to other treatments available for RRMS patients, the U.K.’s MS Trust reported on July 9.
The NHS is obligated to accept treatment recommendations made by NICE and the SMC. In the two countries under NICE’s purview, Ocrevus is expected to be available for prescription within three months, the MS Trust reported in a June release. After this, the NHS will fund the medication.
When NICE initially recommended against Ocrevus’ NHS inclusion, the MS Trust responded by arguing for its inclusion as a valuable additional treatment for RRMS patients.
“We are pleased that NICE has reversed its earlier decision and has now approved ocrelizumab [Ocrevus] as a treatment for [RRMS] in England and Wales,” said Jo Sopala, director of development at the MS Trust.
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“It further expands the range of relapsing MS treatments by offering a different dosing schedule, a different mode of action, minimal monitoring and a low risk of side effects compared to existing disease modifying drugs,” Sopala added.