8 January 2019

Third Biological Treatment Gives More Choice for People with Severe Asthma

Another potentially life-changing treatment should be available to people with a severe form of asthma, NICE says.

Draft guidance published today says that benralizumab is cost-effective for use on the NHS in England and Wales by some adults who have severe eosinophilic asthma and have struggled to control it with inhalers.

This uncommon and relatively uninvestigated form of asthma is believed to affect around 100,000 people in the UK.

Benralizumab, made by AstraZeneca and also known as Fasenra, is a biological therapy which targets and depletes the immune cells (eosinophils) in the blood which cause the condition.

More Choice
It is the third biological treatment for severe eosinophilic asthma approved for NHS use by NICE, following mepolizumab in December 2016 and reslizumab in October 2017. People who are eligible for mepolizumab or reslizumab can now be offered benralizumab.

Benralizumab is given as an injection every 4 weeks for the first three doses, and every 8 weeks thereafter. This makes it potentially more convenient than mepolizumab, which is also injected, and reslizumab, an intravenous infusion, both of which are given every 4 weeks throughout treatment.

Meindert Boysen, director of NICE’s Centre for Health Technology Evaluationsaid: “People with severe eosinophilic asthma that is inadequately controlled often have a severely impaired quality of life – it can hold them back from doing many basic daily tasks, lead to psychological problems including anxiety and depression, and leave them in constant fear of a potentially lethal asthma attack. By keeping their asthma under better control, biological treatments have transformed the lives of some of these sufferers.

“This recommendation of a further biological option demonstrates how a competitive pharmaceuticals market combined with NICE’s appraisal process provides the NHS and patients with value-for-money and choice.”

When benralizumab and another biological treatment are deemed equally suitable for a patient, a prescriber should choose the cheapest option first, according to NICE’s final appraisal document (FAD), published today.

Subject to appeals against the FAD, final guidance will be published next month, and the NHS must make the drug available in England within three months of that date.

The list price of a dose of benralizumab is £1,955, but AstraZeneca must supply it at a confidential discounted price for NHS use, according to its commercial agreement.