The National Institute for Clinical Excellence (NICE) has recommended that anyone with chronic myeloid leukaemia who has failed first line therapy or is in the accelerated and blast phase of the disease should have access to the signal transduction inhibitor imatinib (Glivec). This is a wider group of patients than doctors and campaigners originally thought would have access to the drug.
About 900 patients a year stand to benefit from the new guidance, which will cost the NHS between £11.8m ($18.4m; €18.7m) and £15.8m in the first year.
When it first issued its consultation document on imatinib in May (8 June, p 1352), the institute stated that there was insufficient evidence to recommend the drug for the treatment of chronic or blast crisis phase of the disease. But after considering more evidence and submissions from patients, professionals, and manufacturers, the institute revised its analysis.
Andrew Dillon, the institute's chief executive, denied that the media coverage and lobbying that followed the publication of the original consultation document led to the revised guidance. He described the latest guidance as an “excellent illustration” of the institute's revised appraisal process in action.
“What was interesting is that NICE followed a genuinely consultative process during which it reinforced its commitment to being as transparent as possible; yet because the independent committee that advises us listened to, and acted upon consultation feedback, it was accused of ‘doing a U turn.’
“This was disappointing not only for NICE as we believe that transparency is the way forward, but also for patients who were concerned that NICE had in fact issued guidance when it had not,” he said.