NICE has recommended a new daily pill to treat incontinence and other symptoms of overactive bladder syndrome, which GPs will be able to prescribe.
The final draft guidance has approved vibegron, a bladder muscle relaxant which is produced by Pierre Fabre.
Around 330,000 adults will be eligible to receive the pill following the expected publication of final guidance in September.
GPs could therefore prescribe the pill by October, as NICE has used a quicker ‘cost comparison’ process which means NHS England and ICBs will fund and implement the treatment 30 days after the final guidance.
NICE has stipulated that vibegron is only prescribed if antimuscarinic medicines ‘are not suitable, do not work well enough or have unacceptable side effects’.
The licenced dose of 75mg taken once a day can relax the bladder muscle meaning the bladder has a ‘higher capacity to store urine’ and so reduce symptoms of overactive bladder syndrome.
NICE said clinical trial evidence has shown that vibegron is more effective than placebo for treating symptoms such as urinary urgency and incontinence.
The licenced dosage has not been directly compared with mirabegron, another treatment used if antimuscarinic medicines have not worked, but an indirect comparison ‘suggests it is likely to work as well’.
NICE said: ‘Around 330,000 people in England would be eligible to receive the treatment, which was assessed using a simplified, cost comparison technology evaluation which has also enabled the draft recommendation to be made 12 weeks quicker than under the standard appraisal process.’
The draft guidance, published yesterday, also said that the NHS in Wales ‘must usually provide funding’ for drugs recommended by NICE within two months of publication.
For England, the guidance said: ‘Because vibegron has been recommended through the cost-comparison process, NHS England and integrated care boards have agreed to provide funding to implement this guidance 30 days after publication.’
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Not a terribly good ‘cost-comparison process’ if it specifically excludes a head-to-head comparison trial with existing drugs in the same family, or others used for similar conditions. Can we improve on this please, before patients start asking for it?
Only found one paper comparing Vibegron with mibegron and it was a qualitative study on how patients preferred the drugs. Its final conclusion was no significant difference. Can’t find cost
In UK but in US Interweb says over 400 dollars a month.