Novartis rydapt and Roche roactemra are rejected by British Medical Insurance

Source: rydapt (midostaurin) of Novartis on December 8, 2017 is the first drug approved in Europe for FLT3 mutant acute myeloid leukemia (AML), which is also the only targeted treatment drug But recently, the National Institute of health and Nursing (NICE) has refused to include the drug in the UK health care system In the draft guidelines, the UK cost watchdog stressed that patients who received rydapt chemotherapy lived longer than those who received chemotherapy alone, according to data from randomized controlled trials However, since this clinical trial does not include the elderly over 60 years old, the efficacy of this drug in the elderly is "uncertain" Relevant analysts believe that due to the problem of economic model, there are also great uncertainties in the cost-effectiveness of metoclopramide, including the lack of proper price accounting after recurrence, which will lead to long-term and expensive treatment costs in some cases According to the estimation, rydapt Compared with chemotherapy alone, the most likely cost-benefit estimate of combination chemotherapy is that the cost of treatment increases by £ 62818 for each quality adjusted life year, so it is a huge expenditure for the use of combination chemotherapy in the UK health insurance system Nice UK said the drug is also not suitable for use in the cancer drug fund because "there is no reasonable cost-effectiveness at the current price and the uncertainty of its efficacy has not been confirmed" Similarly, the Roche drug, roactemra (tocilizumab), has been rejected recently Patients with giant cell arteritis are unlikely to have access to the drug through the UK health care system after cost regulators rejected it in the draft guidelines The nice assessment committee in the UK stressed that there is still "significant uncertainty" about how long it will take for patients to use roactemra and the evidence of long-term benefits Giant cell arteritis is a kind of chronic systemic angiogranulomatous inflammation At present, it is usually treated with high dose of corticosteroids, which will gradually decrease with the treatment However, this form of treatment can lead to skin problems such as rashes and weight gain, and long-term hormone use can also lead to diabetes and osteoporosis Clinical data showed that more patients were able to maintain symptomatic remission and needed lower doses of corticosteroids after one year of use of roactemra in combination with corticosteroids, compared with patients who used corticosteroids alone However, the cost-benefit estimate of the drug is at least £ 65800 per qay, which is clearly much higher than the "value for money" standard commonly considered by the UK health insurance system Trials have shown that roactemra's treatment will take up to two years, but some people may need more treatment, which will further improve their cost-benefit estimates