1 Recommendations

1.1 Roxadustat is recommended as an option for treating symptomatic anaemia associated with chronic kidney disease (CKD) in adults only if:

they have stage 3 to 5 CKD with no iron deficiency and
they are not on dialysis at the start of treatment and
the company provides roxadustat according to the commercial arrangement.

1.2 This recommendation is not intended to affect treatment with roxadustat 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 symptomatic anaemia associated with chronic kidney disease includes erythropoiesis stimulating agents (ESAs). Roxadustat is an alternative to ESAs.

A clinical trial comparing roxadustat with darbepoetin alfa (an ESA) shows that roxadustat works as well as darbepoetin alfa.

The cost effectiveness estimates for roxadustat are within what NICE normally considers an acceptable use of NHS resources. So roxadustat is recommended.