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02 October 2014

NICE recommends nalmefene to help people reduce their dependence on alcohol

A drug that can help people who are dependent on alcohol to cut down on the amount they drink, has been recommended in final draft guidance by the National Institute for Health and Care Excellence (NICE).

NICE has not yet published final guidance to the NHS.

In its draft guidance, NICE says nalmefene should be available as an option for those who regularly drink high amounts of alcohol[1]. Nearly 600,000 people will be eligible to receive the treatment.

Nalmefene (also called Selincro and manufactured by Lundbeck) is taken as a tablet once a day on an as-needed basis and reduces the urge to drink. The drug is licensed for use alongside psychosocial support to help people reduce their alcohol consumption and give them the encouragement they need to continue with their treatment.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: “Alcohol dependence is a serious issue for many people. Those who could be prescribed nalmefene have already taken the first big steps by visiting their doctor, engaging with support services and taking part in therapy programmes. We are pleased to be able to recommend the use of namelfene to support people further in their efforts to fight alcohol dependence

“When used alongside psychosocial support nalmefene is clinically and cost effective for the NHS compared with psychosocial support alone.”

Final guidance on the use of nalmefene is expected to be published in November 2014. Until final guidance is published, decisions should be made locally on the funding of the treatment.

Ends

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Notes to Editors

Explanation of terms

  1. According to the World Health Organisation, drinking high amounts of alcohol is defined as consuming more than 60g (7.5 units) per day for men and more than 40g (5 units) for women.

About the guidance

  • The draft guidance (final appraisal document/FAD) is available on the NICE website.
  • This is the first technology appraisal guidance where the recommendations cover both health and social care since the formalisation of the National Institute for Health and Care Excellence and the Health and Social Care Information Centre Regulations 2013. These regulations requires clinical commissioning groups, NHS England and, with respect to their public health functions, local authorities to comply with the recommendations in this appraisal within 3 months of its date of publication.
  • Nalmefene is an opioid receptor modulator, which exhibits antagonist activity at the mu and delta opioid receptors, and partial agonist activity at the kappa opioid receptors. Nalmefene is administered orally as 18 mg film-coated tablets. The maximum dose is 1 tablet daily.
  • Nalmefene has a UK marketing authorisation for ‘the reduction of alcohol consumption in adult patients with alcohol dependence who have a high drinking risk level without physical withdrawal symptoms and who do not require immediate detoxification’.
  • The marketing authorisation also states that 'nalmefene should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption. It should only be started in patients who continue to have a high drinking risk level 2 weeks after initial assessment'.
    • Nalmefene is priced at £42.42 for a pack of 14 tablets or £84.84 for a packet of 28 tablets (excluding VAT; ‘British national formulary’ [BNF], online April 2014). Costs may vary in different settings because of negotiated procurement discounts.
    • The summary of product characteristics lists the following adverse reactions for nalmefene: nausea, dizziness, insomnia and headaches. 

About NICE

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"Alcohol dependence is a serious issue for many people... We are pleased to be able to recommend the use of namelfene to support people further in their efforts to fight alcohol dependence."

Professor Carole Longson, NICE Health Technology Evaluation Centre Director