Nintedanib for treating idiopathic pulmonary fibrosis when forced vital capacity is above 80% predicted

1.1 Nintedanib is recommended as an option for treating idiopathic pulmonary fibrosis in adults, only if:

1.2 This recommendation is not intended to affect treatment with nintedanib 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.

Why the committee made these recommendations

This technology appraisal is for treating idiopathic pulmonary fibrosis in people with a forced vital capacity (FVC) above 80% predicted. Nintedanib is also recommended for people with an FVC between 50% and 80% predicted (NICE technology appraisal guidance 379). Currently, the only option for people with idiopathic pulmonary fibrosis with an FVC above 80% predicted is best supportive care.

Clinical trial evidence shows that nintedanib slows the decrease of lung function compared with placebo in people with idiopathic pulmonary fibrosis with an FVC above 80% predicted. Also, long-term evidence suggests that the effect of nintedanib is maintained over time.

The most likely cost-effectiveness estimates are within what NICE considers an acceptable use of NHS resources. So, nintedanib is recommended.