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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Tezepelumab for treating severe asthma

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    1 Recommendations

    1.1 Tezepelumab is not recommended, within its marketing authorisation, as an add-on maintenance treatment for severe asthma in people 12 years and over, when treatment with high-dose inhaled corticosteroids plus another maintenance treatment has not worked well enough.

    1.2 This recommendation is not intended to affect treatment with tezepelumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop. For young people, this decision should be made jointly by them, their clinician, and their parents or carers.

    Why the committee made these recommendations

    Severe asthma is usually treated with inhaled corticosteroids plus another maintenance treatment. Oral corticosteroids are sometimes used to prevent exacerbations (asthma attacks), but they may have long-term adverse effects. Some people with severe asthma can have biological treatments. Tezepelumab is another biological treatment.

    Clinical trial results show that tezepelumab, when added to usual treatment, reduces exacerbations and oral corticosteroid dose compared with placebo. Tezepelumab has not been compared directly with other biological treatments. Its effectiveness compared with these is unclear because of uncertainties in the indirect treatment comparisons.

    Whether tezepelumab is cost effective is unclear because of uncertainties in the clinical and economic evidence. The cost-effectiveness estimates are also all above the range NICE normally considers to be an acceptable use of NHS resources. So, tezepelumab is not recommended.