NICE Does Not Favor Adding Mayzent to NHS England for Active SPMS

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BY MARISA WEXLER, MS

The National Institute for Health and Care Excellence (NICE) is recommending against Mayzent (siponimod) as a treatment for active secondary progressive multiple sclerosis (SPMS) in the U.K., because its cost-effectiveness relative to an existing treatment for these patients is not known.

NICE’s draft guidance for Mayzent is open for public comment up until July 16.

Mayzent, marketed by Novartis, was approved by the European Commission to treat active SPMS in January, with clinical trials demonstrating the therapy can slow disability progression and relapse rates compared with a placebo.

However, NICE in its opinion noted trial data do not directly compare Mayzent with interferon beta-1b (sold in Europe as Betaferon and Extavia).

Interferon beta-1b is the only treatment now available for active SPMS in the U.K., NICE, a branch of the country’s National Health Service (NHS), acknowledged in its opinion, adding that “few people take it” due to side effects like flu-like symptoms.

“Most people [with active SPMS] do not have any disease-modifying treatment,” it stated.

Without a head-to-head comparison of the two medications, however, NICE is unable to recommend Mayzent as a cost-effective therapy to be included in the NHS, the public health system for England and Wales.

“We know there are currently few, if any treatments available for people with this form of MS, and that siponimod is a promising drug that has the potential to address this unmet clinical need,” Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said in a press release.

“We are, therefore, committed to working with the company to help them address the issues identified by the committee that are highlighted in this draft guidance,” Boysen added.

NICE requested additional analyses to be included in Novartis’s economic model, including comparing Mayzent with best supportive care, and the assumption that treatment efficacy diminishes over time.

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