NICE rejects Velcade (Janssen) as first line therapy for MM

The National Institute for Health and Care Excellence (NICE) has issued draft guidance rejecting the first-line use of Velcade from Janssen, in patients with the Multiple Myeloma, after uncertain data led an independent appraisal committee to conclude that its cost per QALY would likely "substantially" exceed �39,000.

However NICE agreed that treatment with Velcade and dexamethasone was associated with statistically significant improvements in post-induction overall response rates compared with vincristine, adriamycin and dexamethasone, while induction treatment with Velcade, thalidomide and dexamethasone boosted overall response rates and progression-free survival compared with thalidomide and dexamethasone. NICE has asked for further evidence from Janssen on the use of its drug (with dexamethasone and thalidomide) compared with the current standard regimen (cyclophosphamide, thalidomide and dexamethasone), to help it better determine whether the regimen was cost effectuive.

NICE has recommended Velcade as an option for the treatment of progressive Multiple Myeloma in patients who are at first relapse having received one prior therapy and who have undergone, or are unsuitable for, bone marrow transplantation.