A new severe asthma treatment has been approved for use in Scotland. As the process continues for the rest of the UK, our Senior Policy Officer Joseph Clift explains what this could mean for people with one type of severe asthma.
While the dust settles from the recent political developments, there was an important piece of news in Scotland recently where a new asthma treatment is set to become available for the first time on the NHS – one that's targeted at a particular type of severe asthma.
Severe eosinophilic asthma involves an inflammation of the airways linked to a type of white blood cell (eosinophils). One new treatment, mepolizumab (Nucala), has been developed to try and reduce the number of eosinophils and as a result reduce the likelihood of an asthma attack for people with this type of severe asthma.
The UK picture
Health is devolved in the UK, and it's up to each nation to decide whether to recommend new treatments for the NHS. As we will with other new treatments for severe asthma, we have made the case on behalf of people with asthma for mepolizumab to become available, which is why we were delighted to see the Scottish Medicines Consortium issue guidance this week recommending mepolizumab for use in Scotland. This is a huge boost to people with this type of severe asthma, who will now be able to access it on the NHS.
The picture for the rest of the UK is still to be decided, though the early signs from the National Institute for Care and Health Excellence (NICE) are worrying. Despite accepting that the treatment is innovative and has shown benefits to patients in trials, NICE has so far not recommended mepolizumab for the NHS in England. As the processes in Wales and Northern Ireland are linked to NICE, its final decision will be extremely important for the rest of the UK. As our consultation response outlines, we don't believe there has been full consideration of the benefits – particularly how it could transform the quality of life for many people with severe eosinophilic asthma.
Tackling the unmet need for severe asthma
One patient wrote to us recently to give us an insight on how mepolizumab had improved their day-to-day life. His asthma meant that he would be totally out of breath after a short walk, light-headed, and gasping for breath. After taking part in one of the clinical trials for mepolizumab he was able to act as a sole carer to his wife over several years before her death – in his words, he "could not have done this without the aid of the drug."
There are around 250,000 people with severe asthma in the UK, who tend to have difficulty breathing almost all of the time, and often have serious asthma attacks. People with severe asthma often rely on taking oral steroids to treat their symptoms, and while the benefits of this outweigh the disadvantages of any potential long term side effects, new treatments could reduce asthma attacks and reduce the need to take oral steroids – which we know is important for people with severe asthma.
As our understanding of severe asthma has developed we've learnt that not everyone will respond to the same treatments. A few years ago, a new treatment called omalizumab (Xolair) became available in the UK, targeted at people with severe allergic asthma. While Xolair has significantly improved the lives of many that have used it, for the majority of people with severe asthma there is still a significant unmet need for new treatments – one that mepolizumab aims to help address.
Helping people access new treatments
We do not want to see a situation where Scotland is the only place in the UK where mepolizumab is available. We also know that NICE will be considering other new treatments in the coming years for severe asthma that will go through the same process, so mepolizumab is in essence a test case – if this isn't recommended, it's possible future similar treatments will undergo the same kind of challenges without all the benefits being captured in the decision making process. All treatments need to be at a price that the NHS can afford so we want to see NICE and the manufacturer work together to find a solution so that this treatment can be available and help reduce the unmet need for severe asthma treatments.
Unless these new treatments are made available to the patients that would benefit most, people with severe asthma will continue to be at increased risk of life threatening asthma attacks, live with disabling symptoms that often prevent them living their normal lives and higher rates of depression and anxiety. We'll continue to make sure the voices of people with severe asthma are heard so that these treatments are made available as quickly as possible.