In the appraisal of bivalirudin (Angiox, The Medicines Company), NICE has recommended its use in in combination with aspirin and clopidogrel for the treatment of adults with STEMI who are undergoing primary percutaneous coronary intervention. In a very rare turn of events, the appraisal consultation document (ACD) stage is to be missed out, with the guidance being published straight away as a final assessment determination (FAD).
This is probably due to the lack of major issues that were highlighted by HEDS in their report to the committee, together with very clear cost-effectiveness results. The probabilistic sensitivity analysis for the base-case analysis showed that the bivalirudin strategy was dominant in 99.2% of simulations at the £20,000 per QALY threshold. The HEDS team for this report were Emma Simpson, Patrick Fitzgerald, Pippa Evans, Paul Tappenden and Neelam Kalita.
We would expect that this is one piece of guidance that will be adopted quickly, but under value based pricing, what will the price of bivalirudin increase to?
