How are you taking part in this consultation?

You will not be able to change how you comment later.

You must be signed in to answer questions

  • Question on Consultation

    Has all of the relevant evidence been taken into account?

  • Question on Consultation

    Are the summaries of clinical and resource savings reasonable interpretations of the evidence?

  • Question on Consultation

    Are the recommendations sound and a suitable basis for guidance to the NHS?

  • Question on Consultation

    • Are there any aspects of the recommendations that need particular consideration to ensure we avoid unlawful discrimination against any group of people on the grounds of race, gender, disability, religion or belief, sexual orientation, age, gender reassignment, pregnancy and maternity?
The content on this page is not current guidance and is only for the purposes of the consultation process.

Fostamatinib for treating refractory chronic immune thrombocytopenia

Closed for comments This consultation ended on at   Request commenting lead permission

1 Recommendations

1.1 Fostamatinib is not recommended, within its marketing authorisation, for treating refractory chronic immune thrombocytopenia in adults.

1.2 This recommendation is not intended to affect treatment with fostamatinib 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

Treatment for refractory chronic immune thrombocytopenia after thrombopoietin receptor agonists or when they are not suitable includes rituximab or mycophenolate. Fostamatinib would be used after thrombopoietin receptor agonists or when they are not suitable.

Clinical evidence shows that fostamatinib is moderately effective compared with placebo. There is no clinical trial evidence directly comparing fostamatinib with rituximab or mycophenolate. The company chose rituximab with 'watch and rescue' (monitoring until a bleed happens and treatment is needed) as its comparator. However, it did not provide any direct or indirect evidence comparing rituximab with fostamatinib.

This means that the cost-effectiveness estimates for fostamatinib are very uncertain. They are likely to be higher than what NICE normally considers cost effective. So, fostamatinib is not recommended.