LONDON, Dec 9 (APM) - NICE on Tuesday said it is prepared to recommend Janssen's Stelara (ustekinumab) for limited National Health Service use in psoriatic arthritis in after the manufacturer offered a 50% reduction in the price in some groups of patients.
In a statement, NICE outlined draft guidance following a rapid review sparked by the price cut under Janssen's patient access scheme, saying that Stelara could be used by patients unable to use already recommended treatments or who have had treatment with one or more of these drugs.
The Johnson & Johnson unit agreed to provide two vials needed for patients weighing more than 100kg at the same price as a single dose. Stelara costs 10,375 pounds (13,200 euros) on average in the first year and 9,304 pounds (11,800 euros) per year thereafter, according to the NICE statement.
NICE said it has already recommended the anti-TNF treatments, Merck Sharp & Dohme's Simponi (golimumab), AbbVie's Humira (adalimumab), Pfizer's Enbrel (etanercept) and MSD's Remicade (infliximab) in the indication.
It's experts noted that Stelara is a cytokine inhibitor targeting interleukin-12 and interleukin-23.
With the discount, Stelara was deemed cost effective in people for whom anti-TNF drugs are inappropriate with an incremental cost-effectiveness ratio of around 21,900 pounds (27,900 euros) per QALY gained compared with conventional management.
In those who have previously had anti-TNF drugs and for whom such treatment was inappropriate, the ICER was around 25,400 pounds (32,000 euros), while in those who had failed anti-TNF drugs the ICER was 25,300 pounds (32,000 euros).
This placed Stelara within the threshold of 20-30,000 pounds (25-38,000 euros) where NICE deems drugs to be cost-effective in normal circumstances.
Ustekinumab treatment should be stopped if the person’s psoriatic arthritis has not shown an adequate response using pre-defined criteria at 24 weeks, NICE added.
The first draft guidance will go to public consultation for four weeks, then NICE will publish a final draft ahead ahead of full guidance.
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