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Asthma treatment 'no longer value for money'

NICE says omalizumab (Xolair) treatment for severe allergic asthma is no longer good value for money for the NHS, overturning a positive decision in 2007
WebMD UK Health News
Medically Reviewed by Dr Farah Ahmed
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9th November 2012 - A treatment for severe allergic asthma is not being recommended for continued NHS funding in England and Wales, as it is no longer thought to be good value for money.

Omalizumab (Xolair) had been approved by the National Institute for Health and Clinical Excellence (NICE) in 2007 for use in adults and children over 12. The charity Asthma UK says it is "surprised and disappointed" about the decision from NICE, which has been issued in draft guidance today.

The charity has revealed that the treatment helped the sporting career of Team GB Olympic swimmer Jo Jackson. She told Asthma UK: "As someone with severe allergic asthma, I understand how life changing Xolair can be. It allowed me to resurrect my swimming career after I experienced frequent painful asthma attacks during training, causing my ribs to pop out.

"Thanks to Xolair, I was able to get my asthma under control and compete in London 2012 just a couple of years after my future as a swimmer appeared to be in jeopardy due to my asthma."


Omalizumab is used in the UK as an additional therapy to standard asthma care to improve control of severe persistent allergic asthma, where symptoms are poorly controlled. Asthma UK estimates that around 7,000 people in England could benefit from the treatment.

Omalizumab works by blocking immunoglobulin E (IgE) antibodies.

Depending on the required dose, the cost of omalizumab to the NHS ranges from around £1,665 to around £26,640 per patient a year.

New evidence

NICE is the body which assesses treatments for medical conditions and makes recommendations about which medicines and treatments should be funded by the NHS in England and Wales.

It has looked at new evidence for omalizumab since its 2007 guidance before changing its opinion.

In a statement, Sir Andrew Dillon, NICE chief executive says it is aware, "that severe, persistent allergic asthma can have a detrimental effect on a person's life and that omalizumab is an effective therapy for children, adolescents and adults with severe persistent allergic asthma.

"But new evidence that has become available since our original appraisal of omalizumab in 2007 indicates that it is not as clinically or cost-effective as was first thought."

Cost or effectiveness?

Reacting to the NICE guidance in a statement, Asthma UK chief executive Neil Churchill, says: "We are surprised and disappointed by this decision: Xolair is the only treatment that works for some people with severe asthma and its benefits can be life changing.

"There is no doubt that without it, more people with asthma will suffer frequent life-threatening asthma attacks and disabling daily symptoms. We find it hard to understand why NICE wants to change its previous recommendation when there is no major new evidence to suggest that it is any less effective than was previously thought. We strongly urge Novartis [the manufacturer] and NICE to work together to try to find a way to make this vital treatment affordable for the NHS to give to people who really need it."

Until NICE issues final guidance, people already taking omalizumab should be able to continue the treatment until the patient and their doctors consider it appropriate to stop.

Omalizumab remains available adults and children aged over six in Scotland.

Reviewed on November 08, 2012

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