Acoramidis can be used, within its marketing authorisation, as an option to treat wild-type or hereditary transthyretin amyloidosis with cardiomyopathy in adults. Acoramidis can only be used if the company provides it according to the commercial arrangement.
Use the least expensive option of the suitable treatments (including acoramidis and tafamidis), having discussed the advantages and disadvantages of the available treatments with the person with the condition. Take account of administration costs, dosages, price per dose and commercial arrangements.
What this means in practice
Acoramidis must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Acoramidis must be funded in England within 30 days of final publication of this guidance.
There is enough evidence to show that acoramidis provides benefits and value for money, so it can be used routinely across the NHS in this population.
NICE has produced tools and resources to support the implementation of this guidance.
Usual treatment for transthyretin amyloidosis with cardiomyopathy is tafamidis. Acoramidis works in a similar way to tafamidis and would be offered to the same population.
Clinical trial evidence suggests that acoramidis is more effective than placebo. Acoramidis has not been directly compared in a clinical trial with tafamidis, but an indirect comparison suggests that they are likely to have similar clinical effectiveness. There are uncertainties with the clinical-effectiveness evidence, including:
how effective acoramidis is in people with severe heart failure, and
that some people in the trial had both acoramidis and tafamidis.
But these uncertainties are unlikely to have affected the overall results.
A cost comparison suggests that the costs for acoramidis are similar to or lower than those for tafamidis. So, acoramidis can be used.
For all evidence, see the committee papers. For more information on NICE's evaluation of tafamidis, see the committee discussion section in NICE's technology appraisal guidance on tafamidis for treating transthyretin amyloidosis with cardiomyopathy.