The National Institute for Health and Care Excellence issued final draft guidance Thursday recommending NHS reimbursement of Roche's Ocrevus (ocrelizumab) for treating primary progressive multiple sclerosis (PPMS) in adults. The agency had previously rejected use of the disease-modifying treatment in this indication, but reversed its decision after Roche and NHS England reached a commercial arrangement to make the drug available at a lower price following "tough negotiations on both sides."

Meindert Boysen, director of NICE's Centre for Health Technology Evaluation, said "our earlier draft guidance acknowledged that [Ocrevus] represents an important development in the treatment of a condition for which there is a large unmet need. Unfortunately we couldn't recommend it at the price offered at that time because it did not represent a cost-effective use of limited NHS resources."

NICE noted that the average cost of Ocrevus per patient per year is 19 160 pounds ($24 892) at its list price, based on twice yearly 600 mg infusions. The agency indicated that the details of the commercial arrangement are confidential, adding that the cost-effectiveness estimates for the drug at the new lower price compared with best supportive care alone are in the range that NICE considers an acceptable use of NHS resources.

Commenting on the news, Simon Stevens, chief executive of NHS England, said "this innovative deal shows that NHS England is successfully working with companies to make treatments available for patients who need them, through flexibility and thorough negotiation."

Last year, NICE published guidance recommending Ocrevus for some adults with relapsing-remitting form of MS. Meanwhile, in April, Roche reported that sales of the product in the first quarter jumped 67 percent year-over-year to 836 million francs ($821 million).

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