UK's NICE switches chronic HBV drugs

The UK's National Institute for Health and Clinical Excellence (NICE), which reviews treatments, including drugs for use by the National Health Service except in Scotland, has published final guidance recommending the use of Baraclude (entecavir) over Subivo (telbivudine) for the treatment of chronic hepatitis B. The outcome is mixed for the pharmaceutical majors that developed the drugs, with good news for USA-based Bristol-Myers Squibb but bad for Switzerland's Novartis.

The NICE produced both pieces of guidance as part of its rapid single technology appraisal work program. It states that B-MS' Baraclude is recommended as an option for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated. Novartis' agent, Subivo, is not recommended, although patients currently receiving the drug "should have the option to continue therapy until they and their clinicians consider it appropriate to stop," the agency said. This guidance is not applicable for people with chronic hepatitis B who also have hepatitis C, hepatitis D or HIV/AIDS.

Gillian Leng, the NICE's deputy chief executive who led on this guideline, said: "hepatitis B is a disease that can have a serious impact on a person's quality of life, and those with the disease are more likely to develop serious liver problems such as cirrhosis and cancer. The independent committee carefully considered the evidence and concluded that entecavir offered a good use of NHS resources for this condition."