Two months after declining to recommend three atopic dermatitis treatments, the U.K.’s National Institute for Health and Care Excellence (NICE) has had a change of heart.
The drug price watchdog in England and Wales has signed off on AbbVie’s Rinvoq, Pfizer’s Cibinqo and Leo Pharma’s Adbry—which is known as Adtralza outside of the United States. The nod is for treatment of moderate to severe AD if the disease has not responded to at least one systemic immunosuppressant or if these are not suitable for the patient.
When NICE gave the drugs a thumbs-down in April, the agency said it would seek additional cost-effectiveness data and left the door open to reconsidering its position.
The trio joins a host of other treatments for atopic dermatitis in the U.K. Options include topical treatments such as emollients and corticosteroids. Immunosuppressants such as AbbVie’s Restasis can be added if topicals are ineffective.
Targeted biological therapies—like Eli Lilly’s Olumiant and Sanofi and Regeneron’s Dupixent—can be considered if the immunosuppressants fail.
The latest endorsement wasn’t exactly a ranging one in NICE’s final appraisal document, which said the drugs failed to distinguish themselves from Dupixent and Olumiant.
“The results are uncertain,” the regulator wrote of the comparison. “But the most likely cost-effectiveness estimates are within the range that NICE normally considers an acceptable use of National Health Services resources.”
The three drugs were approved in the U.S. for atopic dermatitis in a span of 18 days, starting with Adbry on Dec. 28 of last year.
Rinvoq and Cibinqo are oral JAK inhibitors. Adtralza, which is an injected antibody, becomes the lone approved treatment in the U.K. developed specifically to bind and inhibit the IL-13 cytokine.
The nod is the third that NICE has extended to Rinvoq after previous recommendations for psoriatic and rheumatoid arthritis. The oral drug has also received FDA nods this year for ulcerative colitis and ankylosing spondylitis.
Atopic dermatitis is an inflammatory skin condition and the most common form of eczema. In the U.K., 5% of adults and 6% of teens are affected by atopic dermatitis, AbbVie said. The condition has grown between two- and threefold in most industrialized nations over the last three decades. The endorsement for each of the three drugs is for those 12 and older.
“Atopic dermatitis patients often have individual, complex needs," Professor Anthony Bewley, a consultant dermatologist at Barts Health NHS Trust, said in a release. "This recommendation offers significant new treatment options for atopic dermatitis patients and is an essential step in improving patient experience and quality of life."