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New Medicines
Erenumab is the third CGRP antagonist to be recommended by NICE for preventing migraine. PBR excluded high cost drug, for specialist use only and at the 140 mg dose only. NICE does not expect implementing this guidance to have a significant impact on resources because this is a further treatment option, alongside fremanezumab and galcanezumab, and the overall cost of treatment will be similar once the PAS discounts are applied.
There is no significant new evidence and no significant changes have been made. Although this would meet criteria for Amber Initiated, the patient numbers are not enough to alleviate concerns raised at the previous APC meeting and this will be kept as Amber Retained, with a view to changing to Amber Initiated in a further 12 months following another review
Formulary and Guidelines
NHS England has advised romiplostim and eltrombopag are to be considered first-line treatments for idiopathic thrombocytopenia purpura (ITP) rather than conventional treatments (steroids, immunoglobulin) for the duration of the Covid-19 pandemic.
Update of existing guideline. Revisions to guideline and drug recommendations amended in response to changes in cost.
Update of existing guideline with updated list of preferred first line choices of oral nutritional supplements
Update of current pathway. Includes CGRP antagonists (erenumab, fremanezumab, galcanezumab), migraine prevention drugs (hospital only) for information, and clarification on topiramate contraceptive advice.
Minor amendment to existing guideline, clarifying soft mist inhaler is not a metered-dose inhaler.
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