NHS scraps restriction on availability of J&J's Imbruvica in leukaemia patients


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The NHS has dropped a controversial restriction preventing leukaemia patients from accessing Johnson & Johnson’s tyrosine kinase inhibitor Imbruvica (ibrutinib), expanding its use to cover treatment-naïve patients with chronic lymphoblastic forms of the condition (CLL).

The drug was originally approved in January last year as a treatment for CLL in patients whose cancer had returned following chemotherapy, but despite a recommendation of its efficacy from NICE, NHS England reportedly skirted clinical professionals to restrict its use to only those who had relapsed in the last three years – a cost-cutting decision which reportedly locked out 200 otherwise eligible patients.

Experts warned that such a decision could set a dangerous precedent. Following a review of patient medical data by NHS England’s Chemotherapy Clinical Reference Group, the former organisation conceded that Imbruvica was “more effective than previously thought”.

“The CRG was unanimous in its view that, on clinical grounds, the ibrutinib clinical commissioning treatment criteria in this indication should be amended such that it can be made available as a treatment option for those patients who have had remission durations of three years or more with their preceding line of therapy,” said Professor Stephen Powis, National Medical Director for NHS England, in a letter to the Cancer Drugs Fund, adding: “We would therefore expect access to ibrutinib for this population to commence within the next two weeks.”

Jennifer Lee, a Director at Janssen, commented: “We are delighted that following the evidence submitted by Janssen and our close collaboration with NHS England, they have lifted the criteria and agreed to make ibrutinib available to a broader group of CLL patients in line with existing NICE guidance… This decision will come as welcome news for CLL patients.”

CLL affects 3,700 patients in the UK every year, resulting in death in 1,000 of that number.

Matt Fellows