Log in or register to see all Alerts
New HTA Decisions in England
January 2020
Drug name
MULPLEO® (lusutrombopag)
Company
Shionogi B.V.
Decision date
22/11/2019
Therapeutic area
Blood and immune system conditions
Therapeutic sub area
Blood conditions
Decision
Recommended
Indication
Lusutrombopag is recommended, within its marketing authorisation, as an option for treating severe thrombocytopenia (that is, a platelet count of below 50,000 platelets per microlitre of blood) in adults with chronic liver disease having planned invasive procedures.
Decision Detail
The scope for this technology appraisal includes avatrombopag. However, NICE cannot release any recommendations on avatrombopag until it has an agreed list price in the UK.
Summary
The avatrombopag randomised placebo-controlled trials (ADAPT 1 and ADAPT 2) assessed two doses of avatrombopag: 40 mg for people with a platelet count of between 40,000 and below 50,000 platelets per microlitre of blood and 60 mg for people with a platelet count below 40,000 platelets per microlitre of blood. The lusutrombopag trials (L‑PLUS 1, L‑PLUS 2 and JapicCTI 121944) assessed 3 mg lusutrombopag in people with a platelet count below 50,000 platelets per microlitre of blood. The committee concluded that the trial evidence presented was appropriate for decision making. It further concluded that the evidence showed that avatrombopag and lusutrombopag reduce the number of platelet transfusions before invasive procedures in people with chronic liver disease and thrombocytopenia when compared with placebo. But whether the drugs improve survival compared with platelet transfusions has not been measured. Furthermore, the committee concluded that there was no evidence that either avatrombopag or lusutrombopag was more effective than the other. The economic modelling does not fully account for the benefits for patients and service delivery when using avatrombopag and lusutrombopag. If these are considered, using lusutrombopag would likely save the NHS money. Therefore, lusutrombopag can be recommended for treating thrombocytopenia in people with chronic liver disease who need planned invasive procedures. It is not possible for NICE to make a recommendation for avatrombopag because the drug does not have an agreed UK list price.