Suggested remit: To appraise the clinical and cost effectiveness of elexacaftor in combination with tezacaftor and ivacaftor within its marketing authorisation for treating cystic fibrosis in people with at least one F508del mutation.

Following on from information provided to NICE by the company in October 2020, the appraisal of Elexacaftor, tezacaftor and ivacaftor fixed dose combination therapy for treating cystic fibrosis with the F508del mutation [ID1661] was suspended from NICE’s work programme. As no further information has been received from the company the topic has been discontinued.

Status:
Discontinued
Technology type:
Medicine
Decision:
Selected
Process:
TA
ID number:
1661

Email enquiries

If you have any queries please email scheduling@nice.org.uk

Stakeholders

Companies sponsors
Vertex Pharmaceuticals (elexacaftor, tezacaftor and ivacaftor)
Others
Department of Health and Social Care
 
NHS Enfield CCG
 
NHS England
 
NHS North Norfolk CCG
 
Welsh Government
Patient carer groups
British Lung Foundation
 
CF Voices
 
Contact a Family
 
Cystic Fibrosis Care
 
Cystic Fibrosis Trust
 
Genetic Alliance
 
Genetic Disorders UK
 
Jnetics
 
Muslim Council of Britain
 
NARA – The Breathing Charity
 
South Asian Health Foundation
 
Specialised Healthcare Alliance
 
Together for Short Lives
Professional groups
Association for Respiratory Technology and Physiology
 
Association of Chartered Physiotherapists in Cystic Fibrosis
 
Association of Genetic Nurses and Counsellors
 
Association of Respiratory Nurse Specialists
 
BDA
 
British Geriatrics Society
 
British Inherited Metabolic Disease Group
 
British Paediatric Respiratory Society
 
British Rhinological Society
 
British Society for Gene and Cell Therapy
 
British Society for Genetic Medicine
 
British Society for Human Genetics
 
British Thoracic Society
 
Chartered Society of Physiotherapy
 
Cystic Fibrosis Nurses Association
 
Interstitial Lung Diseases Interdisciplinary Network (ILD-IN)
 
National Heart and Lung Institute
 
Neonatal and Paediatric Pharmacists Group (NPPG)
 
Primary Care Respiratory Society UK
 
Royal College of General Practitioners
 
Royal College of Nursing
 
Royal College of Paediatrics & Child Health
 
Royal College of Pathologists
 
Royal College of Physicians
 
Royal Pharmaceutical Society
 
Royal Society of Medicine
 
UK Clinical Pharmacy Association
 
UK Cystic Fibrosis Pharmacy Group
 
UK Cystic Fibrosis Medical Association
 
UK Genetic Testing Network
 
UK Psychosocial Professionals in Cystic Fibrosis Group
 
4-Front
Associated public health groups
Public Health England
 
Public Health Wales
Comparator companies
Accord UK (carbocisteine)
 
Aurobindo Pharma – Milpharm (carbocisteine)
 
Brown & Burk (carbocisteine)
 
Dr Reddy’s (carbocisteine)
 
Essential Pharmaceticals (pancreatin)
 
Flamingo Pharma (carbocisteine)
 
Intrapharm Laboratories (carbocisteine)
 
Janssen (pancreatin)
 
Merck Serono (pancreatin)
 
Mylan (pancreatin)
 
Pharmaxis (mannitol dry powder for inhalation)
 
Roche Products (dornase alfa)
 
Sanofi (carbocisteine)
 
Typharm (carbocisteine)
 
Zentiva (carbocisteine)
General commentators
All Wales Therapeutics and Toxicology Centre
 
Allied Health Professionals Federation
 
Board of Community Health Councils in Wales
 
British National Formulary
 
Care Quality Commission
 
Department of Health, Social Services and Public Safety for Northern Ireland
 
Healthcare Improvement Scotland
 
Medicines and Healthcare Products Regulatory Agency
 
National Heart and Lung Institute
 
National Association of Primary Care
 
National Pharmacy Association
 
NHS Alliance
 
NHS Confederation
 
Scottish Medicines Consortium
 
Welsh Health Specialised Services Committee
Relevant research groups
British Association for Lung Research
 
CF Unite
 
Cochrane Airways Group
 
Cochrane Cystic Fibrosis and Genetic Disorders Group
 
Genomics England
 
MRC Clinical Trials Unit
 
National Institute for Health Research
 
UK Cystic Fibrosis Gene Therapy Consortium

Timeline

Key events during the development of the guidance:

Date Update
25 January 2023 Discontinued. Following on from information provided to NICE by the company in October 2020, the appraisal of Elexacaftor, tezacaftor and ivacaftor fixed dose combination therapy for treating cystic fibrosis with the F508del mutation [ID1661] was suspended from NICE’s work programme. As no further information has been received from the company the topic has been discontinued.
23 October 2020 The interim data collection agreement for Vertex’s cystic fibrosis modulator therapies has been updated to include elexacaftor, tezacaftor and ivacaftor (https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-technology-appraisal-guidance/data-collection-agreement) following the announcement of a 4-year deal agreed by NHS England & NHS and Vertex (https://www.england.nhs.uk/2020/06/nhs-patients-among-first-in-europe-to-benefit-from-landmark-deal-for-cystic-fibrosis-treatment/) . The updated interim data collection agreement enables eligible patients continued access to Vertex’s cystic fibrosis modulator therapies while further data is collected to inform a future NICE technology appraisal. In addition, future therapeutic indications (for ivacaftor, lumacaftor/ivacaftor, tezacaftor/ivacaftor or ivacaftor/tezacaftor/elexacaftor) that receive a marketing authorisation from the Medicines and Healthcare products Regulatory Agency or the European Medicines Agency (applicable to the United Kingdom) during the term of the interim data collection agreement will automatically be considered part of the agreement and formalised through a contract addendum. NICE is currently unable to make a recommendation about the use of elexacaftor, tezacaftor and ivacaftor combination therapy in the NHS. In line with the updated interim data collection agreement the company has confirmed that it will provide an evidence submission towards the end of the interim access agreement initiating the NICE appraisal. NICE will contact stakeholders about participating in the new appraisal in due course.
23 October 2020 Suspended. Appraisal suspended
02 July 2020 Following the announcement that NHS patients will be among first in Europe to benefit from access to ivacaftor, tezacaftor and elexacaftor, the appraisal of this triple therapy is now paused. NICE will work with the company and the NHS on continued data collection to inform a future appraisal. New details and timelines for an appraisal will be confirmed in due course. https://www.england.nhs.uk/2020/06/nhs-patients-among-first-in-europe-to-benefit-from-landmark-deal-for-cystic-fibrosis-treatment/
02 June 2020 Following a request from Vertex Pharmaceuticals, we have had to reschedule this technology appraisal. Vertex has not provided NICE with an evidence submission by the deadline that took into account an expected licensing date towards the end of this calendar year. The appraisal cannot proceed without an evidence submission from the company. Vertex has indicated that it needs more time to allow for further data from the clinical and real world evidence studies to be included. They have committed to providing us with a full evidence submission by January 2021 at the latest. The first committee has been rescheduled to 12 August 2021 on this basis. We appreciate that this is very disappointing for those waiting with great anticipation for the triple therapy to become available, especially in the context of the coronavirus COVID-19 pandemic. Every week that goes by without an evidence submission from the company will lead to delay in the availability of NICE guidance. We will continue to work with Vertex on the evidence we need, and stand ready to receive their submission at the earliest opportunity between now and January 2021.
19 February 2020 Invitation to participate
19 February 2020 In progress. Invitation to participate
03 February 2020 (10:00) Scoping workshop (Manchester)
12 December 2019 - 17 January 2020 Consultation on suggested remit, draft scope and provisional stakeholder list of consultees and commentators

For further information on our processes and methods, please see our CHTE processes and methods manual