NICE approves Cimzia but blocks Ilumetri in treatment of psoriasis

UK drug watchdog NICE has announced two new recommendations relating to medicines for the treatment of psoriasis, approving UCB Pharma’s Cimzia (certolizumab pegol) for use on the NHS, but rejecting Almirall’s Ilumetri (tildrakizumab).

The organisation chose to recommend Cimzia for the treatment of severe plaque psoriasis in adult patients that have proven unresponsive to other systemic treatments such as phototherapy, methotrexate and ciclosporin, or if these treatments are not found to be unsuitable.

The decision was based on data in which Cimzia demonstrated a 66.7% response rate of patients achieving a score of 75 on the Psoriasis Area Severity Index (PASI) after 12 weeks of treatment, when administered in 400mg fortnightly. For those receiving 200mg over the same period, the overall response rate was 61.3%; this is in comparison to just 5% with placebo.

The same data helped the drug secure European approval in July as the first Fc-free, PEGylated anti-TNF treatment option for moderate-to-severe plaque psoriasis. NICE judged the drug to offer greater benefit to patients than etanercept, the current NHS-funded standard of care, and – at an estimated cost of £6,793 per patient per year – could be judged as cost-effective compared to other biological treatments. It is anticipated that between 17,000 and 28,000 people could benefit from the treatment.

However, Ilumetri was rejected in the treatment of moderate to severe plaque psoriasis, despite positive data illustrating that 63% of patients using the drug achieved PASI 75 over 12 weeks. NICE said that the therapy carried a price disproportionately higher than comparable biologic treatments, and so could not be considered a cost-effective use of NHS resources.

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