NICE (Multiple) Technology Appraisal Guidance No 251
Dasatinib, nilotinib and standard-dose imatinib for the
first-line treatment of chronic myeloid leukaemia (part review of
technology appraisal guidance 70)
This guidance states that:
- Standard-dose imatinib (400 mg per day for
patients in chronic phase) is recommended as an option for the
first-line treatment of adults with chronic phase
Philadelphia-chromosome-positive chronic myeloid leukaemia
(CML).
- Nilotinib is recommended as an option for the
first-line treatment of adults with chronic phase
Philadelphia-chromosome-positive CML if the manufacturer makes
nilotinib available with the discount agreed as part of the patient
access scheme (PAS).
- Dasatinib is not recommended for the first-line
treatment of chronic phase Philadelphia-chromosome-positive
CML.
- People currently receiving dasatinib in this
indication should be able to continue treatment until they and
their clinician consider it appropriate to stop.
Web reference for appraisal and other
related documents: http://www.nice.org.uk/guidance/TA251
NHSScotland should note
that:
1. No important differences were identified
for this NICE appraisal and Healthcare Improvement Scotland advises
that the recommendations are as valid for Scotland as for England
and Wales.
2. The recommendations replace the
recommendations in TA70 relating to the use of imatinibin this
indication.
The Scottish Medicines Consortium (SMC) has
previously accepted imatinib and nilotinib for the treatment of
adult patients with newly diagnosed
Philadelphia-chromosome-positive CML in the chronic phase. This SMC
advice takes account of the benefits of a PAS for nilotinib and is
contingent upon the continuing availability of the PAS in
NHSScotland. The SMC has not previously issued guidance to
NHSScotland on the use of dasatinib, for first-line treatment in
this specific indication.
3. NHSScotland should take account of the NICE
appraisal and this Healthcare Improvement Scotland email in its
planning, funding and provision of services to ensure that
recommended drugs or treatments are made available to meet clinical
need.
4. Copies of the NICE appraisal can be
downloaded from http://www.nice.org.uk . Also on the
website are tools that NICE has developed to help organisations
implement this guidance. NICE MTA costing templates now include the
NHSScotland boards. However, please note that the care pathway
described in the costing tool may not completely reflect practice
in NHSScotland.
Finally, an easy to read summary of the
appraisal, called "understanding NICE guidance" is published on the
NICE website to provide information for patients and the
public.
5. Healthcare Improvement Scotland advice
represents the evidence-based view of Healthcare Improvement
Scotland.
6. This advice does not override or replace
the individual responsibility of health professionals to make
appropriate decisions in the circumstances of their individual
patients, in consultation with the patient and/or guardian or
carer.
7. No other publications on the NICE appraisal
will be issued by Healthcare Improvement Scotland.
If you need further assistance, please contact
Eleanor Brownlee in
the first instance - tel 0141 225 6873
Published Date: 25 April 2012
