Lenalidomide (Revlimid; Celgene) in combination with dexamethasone has a marketing authorisation for treating 'multiple myeloma in adult patients who have received at least one prior therapy'. It also has a marketing authorisation for 'previously untreated multiple myeloma in people who are not eligible for transplant'.
The recommended starting dosage is 25 mg orally once daily on days 1 to 21 of repeated 28‑day cycles.
Lenalidomide is available as a 21‑capsule pack. The cost per pack (excluding VAT; BNF online, accessed April 2019) varies according to capsule size: £3,426.00 (2.5 mg), £3,570.00 (5 mg), £3,675.00 (7.5 mg), £3,780.00 (10 mg), £3,969.00 (15 mg), £4,168.50 (20 mg) and £4,368.00 (25 mg).
The company has a commercial arrangement. This makes lenalidomide available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.