SMC nod for Amgen's multiple myeloma treatment carfilzomib in combination with dexamethasone

Amy Schofield 08 August 2017

The Scottish Medicines Consortium (SMC) has published its advice accepting the use of Amgen's KYPROLIS (carfilzomib) in combination with dexamethasone alone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. The advice takes into account the continuing availability of the Patient Access Scheme (PAS) agreed or a list price that is equivalent or lower.

The SMC advice guides NHS Boards and Area Drug and Therapeutic Committees on the use of carfilzomib within NHS Scotland. It has taken into account the views of patient group representatives and clinical specialists in a Patient and Clinical Engagement meeting. 

Clinical experts consulted by the SMC considered that carfilzomib plus dexamethasone is a therapeutic advance as it provides an opportunity to increase overall and progression-free survival when compared to bortezomib plus dexamethasone; one of the current standard of care for relapsed multiple myeloma. It also concluded that carfilzomib is associated with a reduced rate of peripheral neuropathy.

The key evidence to support the use of carfilzomib in combination with dexamethasone in the treatment of adults with relapsed multiple myeloma was based on the large Phase 3 randomised study, ENDEAVOR. This first ever head-to-head clinical trial, comparing two proteasome inhibitors, showed that adults treated with carfilzomib plus dexamethasone lived almost twice as long without their cancer progressing compared to bortezomib plus dexamethasone.

Shelagh McKinlay, Policy and Public Affairs Officer, Myeloma UK, said: “This is great news for patients in Scotland. The approval of carfilzomib and dexamethasone for use on the NHS gives myeloma patients, whose cancer has come back, an important new treatment option.

“We are especially pleased that the approval covers all patients who have had one prior treatment as carfilzomib and dexamethasone has been shown to be very effective in prolonging survival in relapsed myeloma patients, and should be available to doctors as a prescribing option for their eligible patients.” 

Following the publication of the SMC’s advice, NHS Boards in Scotland now have a maximum of 60 days to include carfilzomib in their formularies for the treatment of patients with multiple myeloma who have received at least one prior therapy. The advice is contingent upon Amgen UK providing carfilzomib to NHS Scotland within the terms of the agreed PAS. 

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