1.1 Ruxolitinib is recommended, within its marketing authorisation, for treating polycythaemia vera in adults who cannot tolerate hydroxycarbamide (also called hydroxyurea) or when the condition is resistant to it. It is only recommended if the company provides it according to the commercial arrangement.
Why the committee made these recommendations
Standard treatment to control blood cell count (cytoreductive therapy) in polycythaemia vera is hydroxycarbamide or interferon alfa. Ruxolitinib would be used for people who cannot tolerate hydroxycarbamide or when the condition is resistant to it.
Results from clinical trials suggest that ruxolitinib is more effective than standard treatment at controlling blood cell counts and reducing spleen size. But whether it increases how long people live is uncertain.
Because of the uncertainty in the clinical-effectiveness evidence, the cost-effectiveness estimates need to be towards the lower end of the range that NICE considers an acceptable use of NHS resources. They are below this lower end, so ruxolitinib is recommended.