NICE approval for the drug is subject to the caveat that it be supplied within the terms of the commercial agreement.
Ocrelizumab is a humanised monoclonal antibody that selectively targets CD20-expressing B cells. Although its mechanism of action in MS has not been fully elucidated, it is presumed to involve immunomodulation via a reduction in the number and function of these B-cells. Innate immunity and total T-cell numbers are not affected.
Ocrevus (ocrelizumab) is indicated for:
- treatment of relapsing forms of MS with active disease defined by clinical or imaging features, and
- treatment of early primary progressive MS in terms of disease duration and level of disability, and with imaging features characteristic of inflammatory activity.
It is the first disease-modifying agent to be licensed for the treatment of both relapsing and primary progressive forms of MS.
Explaining its decision to approve ocrelizumab, NICE states that given the unmet clinical need for disease-modifying treatments to slow the worsening of disability in MS, the most plausible cost-effectiveness estimates for ocrelizumab at the agreed price compared with best supportive care alone are in the range that it considers to be an acceptable use of NHS resources.