The latest decision from the National Institute for Health and Care Excellence (NICE), is an initial rejection of Ninlaro® (ixazomib, Takeda) for the treatment of Multiple Myeloma (MM) patients. This follows on from a draft guidance issued in June this year, in which NICE explained that the benefits with ixazomib were not deemed to be sufficient when weighed up alongside cost-effectivity criteria.
Ixazomib is one of Takeda’s key players in its Heme-Onc portfolio and is currently approved by both the US.Food and Drug Administration (FDA) and European Medicines Agency (EMA) for use in combination with lenalidomide and dexamethasone, to treat MM patients that have received one or more prior therapies. However, in clinical practice it is often given to patients with Relapsed and Refractory Multiple Myeloma (RRMM) for whom other treatments have been exhausted, and is therefore a valuable option for this patient set. It also offers convenience to patients as it is an all-oral combination which can be self-administered at home. However, NICE have argued that it does not offer a cost-effective benefit over other options, a decision further supported by the fact that the Overall Survival (OS) benefit was less pronounced in later assessments. This will be disappointing news for MM patients in England and Wales, who will be hoping that Takeda can now work with NICE to overturn this initial rejection decision.