The MS Trust is very disappointed that NICE does not recommend ozanimod (Zeposia) as an NHS treatment in England and Wales.
In its draft recommendation, NICE acknowledges that ozanimod reduces the number of relapses and brain lesions compared to beta interferon (Avonex) but is unsure of ozanimod’s ability to slow down disability progression. As a result, ozanimod is not considered to be cost-effective for the NHS.
This is NICE’s initial decision and they have asked the manufacturer for more detailed evidence and analysis of the data. The MS Trust has been taking part in the appraisal of ozanimod and we will be replying to NICE’s initial decision.
If you wish to comment on the draft recommendation, you can do so through the NICE website by 5pm, 12 February 2021.
The NICE appraisal committee will meet again to review all the comments received and expects to publish its final decision later this year.
Ozanimod is taken as a tablet, once daily. A low dose is taken initially which is gradually increased over the first week. This reduces the risk of slowing the heart rate.
In a two year clinical trial, ozanimod reduced the risk of relapses by 38% compared to beta interferon (Avonex) and reduced the number of new active lesions seen on MRI. There was no significant difference in disability progression between ozanimod and Avonex.
The most common side effects reported in clinical trials were nasopharyngitis (common cold), reduced white blood cell count, headache, chest infections and urinary tract infections. Ozanimod caused temporary increases in liver enzymes which generally returned to normal levels without the need to stop treatment.
Ozanimod belongs to the same class of drugs as Gilenya (fingolimod). It works by retaining lymphocytes (immune cells) in lymph nodes. The number of lymphocytes reaching the brain is decreased, which reduces the immune attack on nerve cells in the brain and spinal cord.
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