2 The technology
2.1 Nintedanib (Ofev, Boehringer Ingelheim) targets 3 growth factor receptors involved in pulmonary fibrosis. Nintedanib is thought to block the signalling pathways involved in fibrotic processes, and may reduce disease progression by slowing the decline of lung function. It is administered orally. Nintedanib has a marketing authorisation in the UK 'in adults for the treatment of idiopathic pulmonary fibrosis'.
2.2 The summary of product characteristics states that the most frequently reported adverse reactions associated with using nintedanib are diarrhoea, nausea and vomiting, abdominal pain, decreased appetite, decreased weight and increased hepatic enzyme concentrations in the blood. For full details of adverse reactions and contraindications, see the summary of product characteristics.
2.3 The recommended dosage of nintedanib is 150 mg twice daily. The list price of nintedanib is £2151.10 for 60 capsules (taken from the company submission and confirmed in Monthly Index of Medical Specialities [MIMS] online, accessed June 2015). This equates to a daily cost of £71.70 (2 capsules per day). The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of nintedanib, with the discount applied at the point of purchase or invoice. The level of the discount is commercial in confidence. The Department of Health considered that this patient access scheme does not constitute an excessive administrative burden on the NHS.