NICE recommends conditional use of Esbriet in specific population with idiopathic pulmonary fibrosis.- Roche.

The National Institute for Health and Care Excellence has published final guidelines recommending the use of Esbriet (pirfenidone), from Roche, as an option for treating idiopathic pulmonary fibrosis in adults only if:the person has a forced vital capacity (FVC) between 50% and 80% predicted, the company provides pirfenidone with the discount agreed in the patient access scheme and treatment is stopped if there is evidence of disease progression (an absolute decline of 10% or more in predicted FVC within any 12-month period).

The committee noted that the evidence came from 4 randomised double-blind placebo-controlled phase III trials (CAPACITY 1, CAPACITY 2, ASCEND and SP3) and other observational data. The appraisal committee reviewed existing and new data on the clinical and cost effectiveness of pirfenidone, having considered evidence on the nature of idiopathic pulmonary fibrosis and the value placed on the benefits of pirfenidone by people with the condition, those who represent them, and clinical experts.

NICE said Esbriet could not be considered a cost-effective use of NHS resources for adults with mild to moderate IPF since the most plausible incremental cost-effectiveness ratio (ICER) lay somewhere between about �25,700 and �28,900 per quality-adjusted life years (QALY) gained compared with best supportive care, and was associated with uncertainties that had the potential to substantially increase this.