The Pharmaceutical Journal
Vol 279 No 7475 p461
27 October 2007

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NICE gives response-rebate scheme for bortezomib the go-ahead

A scheme in which the NHS is refunded the cost of bortezomib (Velcade) for multiple myeloma patients who fail to respond adequately to the drug will go ahead.

The response-rebate scheme was proposed by the drug’s manufacturer Janssen-Cilag and modified by the National Institute for Health and Clinical Excellence during its technology appraisal of the drug (PJ, 9 June, p663).

This week NICE issued final guidance that recommends bortezomib monotherapy as an option for the treatment of progressive multiple myeloma in people who are at first relapse, have received one prior therapy and have already undergone, or are unsuitable for, bone marrow transplantation.

However, the guidance specifies that treatment should only be continued in people who have a complete or partial response to the drug after four cycles. A complete or partial response is defined as a reduction in serum M protein of 50 per cent or more.

For people who have less than a partial response after a maximum of four cycles, bortezomib should be stopped and the manufacturer will reimburse the full cost of the drug.

Andrew Dillon, chief executive of NICE, commented: “The scheme proposed by the manufacturer and amended by NICE will ensure that all patients suitable for treatment with bortezomib at first relapse will get the chance to see if the drug works well for them. This is a win-win situation for patients and the NHS.”

The Department of Health and Janssen-Cilag will be responsible for setting up the scheme, which will continue until NICE’s next review of bortezomib scheduled for September 2010.