Ruxolitinib is recommended, within its marketing authorisation, as an option for treating acute graft versus host disease (GvHD) that has an inadequate response to corticosteroids in people 12 years and over. Ruxolitinib is only recommended if the company provides it according to the commercial arrangement.
Why the committee made this recommendation
First-line standard care for acute GvHD is corticosteroids. If corticosteroids have not worked well enough, second-line standard care can include extracorporeal photopheresis, mycophenolate mofetil, etanercept and infliximab. Ruxolitinib is an alternative to these second-line treatments.
Clinical trial evidence shows that acute GvHD is more likely to improve with ruxolitinib than with standard care. Treatment failure (that is, need for another treatment, relapse of the underlying disease that led to the need for a transplant, or death) may also be less likely in people who have ruxolitinib.
The most likely cost-effectiveness estimate for ruxolitinib is within the range that NICE considers an acceptable use of NHS resources. So, ruxolitinib is recommended.