NICE ‘no’ for Roche’s Ocrevus in primary progressive MS

The National Institute for Health and Care Excellence has concluded that Roche’s Ocrevus should not be funded on the NHS for the treatment of primary progressive multiple sclerosis (PPMS) in adults.

In draft guidelines, the committee agreed that the drug is a "step change" in treatment for the condition, but said it had not seen evidence of any additional benefits not captured in its cost-effectiveness assessment.

PPMS affects around 14 percent of MS patients at the time of diagnosis.

Clinical results show that Ocrevus (ocrelizumab) can slow the worsening of disability in people with the condition, but the drug’s cost per QALY compared with best supportive care was estimated to be higher than what is normally considered value for money for the NHS.

Ocrevus is first-in-class, humanised monoclonal antibody designed to selectively target CD20-positive B cells, a specific type of immune cell thought to be a key contributor to myelin and axonal (nerve cell) damage, which can lead to disability in people with MS.

The drug’s approval in Europe in January this year marked the first time a medicine was licensed for use in patients with PPMS, the most debilitating form of the disease, as well as widening treatment options for those with RMS forms of the condition.

Genevieve Edwards, director of External Affairs at the MS Society, said NICE’s decision to bar patients from access to the Ocrevus in this setting is "deeply disappointing".

"We’ve been waiting a lifetime for an effective treatment for primary progressive MS, and it is simply unacceptable to deny people a treatment they urgently need.

"Thankfully this isn’t the end of the road, and we know the manufacturers are talking to NICE and NHS England about their options. We urge both sides to come together and find a solution that allows everyone who could benefit, access to ocrelizumab as soon as possible."

The drug was recommended by NICE for the treatment of some adults with relapsing-remitting MS in draft guidance in June.

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