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ID6451 nemolizumab DG for consultation indev [noCON].docx

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1 Recommendations

1.1

Nemolizumab should not be used to treat moderate to severe prurigo nodularis in adults when systemic treatments are suitable.

1.2

This recommendation is not intended to affect treatment with nemolizumab 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 healthcare professional consider it appropriate to stop.

What this means in practice

Nemolizumab is not required to be funded in the NHS in England to treat moderate to severe prurigo nodularis in adults when systemic treatments are suitable. It should not be used routinely in the NHS in England.

This is because the available evidence does not suggest that nemolizumab is value for money.

Why the committee made these recommendations

Usual treatment for moderate to severe prurigo nodularis is best supportive care. This includes systemic treatments (treatments that work throughout the body), such as corticosteroids and immunosuppressants.

Clinical trial evidence shows nemolizumab relieves itch and reduces the number of nodules compared with placebo.

There are uncertainties in the economic model. This is because of how it defines treatment response and how it reflects quality of life. Also, it does not appropriately consider what happens if the condition only partially responds to treatment.

Because of the uncertainties in the economic model, it is not possible to determine the most likely cost-effectiveness estimates for nemolizumab. So, it should not be used.

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