NICE ‘not able to recommend dronedarone’

NICE has issued draft guidance advising against NHS funding for dronedarone (Multaq) to treat atrial fibrillation.

The evidence provided to the independent appraisal committee indicates that dronedarone is less effective and costs considerably more than existing treatments for controlling atrial fibrillation.

Interested parties now have an opportunity to comment on the draft recommendations made by the independent appraisal committee.

Andrew Dillon, Chief Executive of NICE said: “NICE is keen to provide guidance which can help people with atrial fibrillation, but we need to be sure that any treatment we recommend offers real additional benefits for patients – and we need to be confident that those benefits justify the cost to the NHS. In this case, dronedarone costs more, and has not been shown to be more effective, than other treatments for atrial fibrillation.

“The manufacturer’s own data indicated that dronedarone was the least effective of currently used anti-arrhythmic drugs for controlling atrial fibrillation. The drug is much more expensive than existing treatments and the evidence suggests that on balance it offers little additional health benefit.”

The committee also considered information from patients and clinical specialists which indicated that, even though dronedarone doesn’t work as well as existing treatments for atrial fibrillation, it may have fewer side effects so would be welcomed as an alternative option. However, the committee noted that the evidence provided was collected over a relatively short period and it was less certain what the longer-term side effects of dronedarone would be.

“This uncertainty, alongside the drug’s lower effectiveness and higher cost meant that the committee was not able to recommend dronedarone,” Dillon added.