NICE UK draft guidance recommends rivaroxaban for pulmonary embolism


The UK National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending rivaroxaban (Xarelto, Bayer Healthcare) as a clinically and cost-effective option for treating pulmonary embolism and preventing recurrent deep vein thrombosis and pulmonary embolism after acute pulmonary embolism in adults. The draft guidance has been issued to consultees for appeal and published on the NICE website for information.

Rivaroxaban is an orally administered anticoagulant. It has a UK marketing authorisation for the treatment of deep vein thrombosis and pulmonary embolism, and prevention of recurrent deep vein thrombosis and pulmonary embolism in adults.

Carole Longson, NICE Health Technology Evaluation Centre director, said: “The Committee heard from the patient expert that the regular monitoring and dose adjustment needed with warfarin, which needs regular visits to hospital or GP appointments, can be costly and inconvenient, and means some people might have to take time off work. Also, because warfarin has many drug interactions, it may be unsuitable for people with comorbidities. In addition, the Committee heard that warfarin has various food interactions which often require people to adjust and monitor their diet and lifestyle. Rivaroxaban therefore represents a significant potential benefit for people with pulmonary embolism and deep vein thrombosis because it avoids the need for initiation with heparin and the subsequent transition to warfarin.”

The draft guidance is now with consultees including Bayer Healthcare, national patient and carer groups and bodies representing health professionals, who have the opportunity to appeal against it. According to NICE, until a final guidance is issued, NHS bodies should make decisions locally on the funding of specific treatments. Final guidance is likely to be published in May 2013.

The draft guidance can be found on the NICE website