NICE Issues Final Draft OK For Brilique

The UK National Institute for Health and Clinical Excellence (NICE) has issued a final draft guidance recommending the use of AstraZeneca’s antiplatelet drug Brilique (ticagrelor) in the treatment of acute coronary syndromes (ACS).

Every year, around 200,000 people in England are diagnosed with acute coronary syndromes, which cover a range of conditions from unstable angina to myocardial infarction (MI).

NICE’s draft guidance for Brilique recommends its use, in combination with aspirin, as a treatment option in people with ST-segment-elevation myocardial infarction (STEMI) who are to undergo primary percutaneous coronary intervention (PCI) and in people with non-ST-segment-elevation myocardial infarction (NSTEMI).  NICE also recommends Brilique as a treatment option for people with unstable angina.

Professor Carole Longson, director of the health technology evaluation centre at NICE, commented that although the mortality from myocardial infarction and other cardiovascular causes has declined in recent years, an increasingly ageing population, coupled with worrying trends in the incidence of obesity and lifestyles that involve less exercise, make the management of ACS a continuing high priority.

The Institute’s independent appraisal committee concluded from the evidence that taking Brilique alongside aspirin significantly reduces myocardial infarction and death from cardiovascular disease, by 16% and 21% respectively, compared with Sanofi and Bristol-Myers Squibb’s Plavix (clopidogrel) with aspirin, Professor Carole Longson noted, and added that the draft guidance recognises the potential of Brilique “in providing the NHS in England and Wales with another valuable tool to enable it to deal more effectively with the long-term management of ACS.”

The draft guidance has been welcomed by the professor of cardiovascular disease prevention at St George’s Hospital NHS Trust Research Centre, Kausik Ray, who called it a “significant step forward for patients and doctors” which will “hopefully have a positive effect on many patients with ACS treated by the NHS.”

The total cost of the management of heart attacks and unstable angina in the UK is around £1.5 billion a year, commented AstraZeneca.

Ticagrelor has now been approved in 43 countries, including in the European Union (EU) under the trade name Brilique and in the US, Canada and Brazil as Brilinta.  The product currently has price approvals in 19 countries and reimbursement authorisations in nine.


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