In the balance – two vital decisions that could shape severe asthma treatment for years to come

25 October 2016

LungsBy Joseph Clift, Senior Policy Officer at Asthma UK

Two new drugs with the potential to transform the lives of people with some of the most debilitating forms of asthma are being considered for use on the NHS by the National Institute for Care and Health Excellence (NICE).

The decision stakes are high. Approval for the drugs - Mepolizumab and Reslizumab - could offer hope to thousands of people with a form of severe asthma that doesn’t respond to current treatments. However, rejection would come as a huge blow to those that will not have seen any new targeted treatments in their lifetime.

At a time when Asthma UK is calling for much-needed investment in asthma research from government and industry, rejection of these innovative treatments could serve as a disincentive to future asthma research.

Severe Asthma

People with severe asthma are desperate for new treatments that could help prevent attacks without significant side-effects, and while thousands could potentially benefit from the drugs being considered, there are other types of severe asthma that have no new treatments on the horizon. By demonstrating that there is a UK market for these types of treatment we can help to make sure that future breakthroughs in asthma are developed.

For the vast majority of people with asthma, their inhalers can help them maintain control of their symptoms if used correctly. But for people with severe asthma, they face a different and unpredictable day-to-day reality because standard treatments are not effective for them.

Mepolizumab and Reslizumab have been developed to treat severe eosinophilic asthma. This is a distinct type that involves an inflammation of the airways linked to a particular type of white blood cell (eosinophils).

A similar drug, Omalizumab (or Xolair) became available in 2007. But while it has been transformational for some, it targets a different type of severe asthma. This is why the new drugs being considered by NICE are so important – they offer hope of new treatments to patients that have no targeted therapies available. 

Making the case

Asthma UK has made the patient voice clear as each of these new drugs is considered, highlighting to NICE the unmet need that could start to be addressed with such new innovative treatments.

Earlier in the year, Asthma UK helped to persuade the Scottish Medicines Consortium to make Mepolizumab available to patients in Scotland. NICE is yet to reach a final decision for England, which will also impact on its availability in Wales and Northern Ireland.

There is no denying these are high cost treatments, but the benefits far outweigh the cost by transforming the lives of people who find themselves fighting to breathe on a daily basis. The experience of Xolair has shown that these asthma treatments can be carefully provided through specialist centres - making use of multidisciplinary teams and diagnostic tests to ensure the drugs are provided to those that will benefit most.

This is a crucial time for NICE, the drug developers and for people with severe asthma. We need to ensure that clinically-effective treatments are made available for people with severe asthma at a price that the NHS can afford as quickly as possible across the UK. With a further treatment, Benralizumab, recently reporting encouraging clinical trial results, we could very quickly go from no targeted therapies for these patients to three – providing hope to thousands of people, stopping asthma attacks, and saving lives.