In England and Wales, the National Institute for Health and Clinical Excellence (NICE) has finalized guidelines for the use of Revlimid (lenalidomide) in combination with dexamethasone (Decadron). The guidelines recommend the use of Revlimid for myeloma patients who have already received two or more prior therapies.

NICE is an independent organization that provides medical opinions to the National Health Service (NHS), the government-funded health care system in the U.K.

Based on NICE’s recommendation, the NHS will only pay for Revlimid for patients who have received at least two prior therapies. The NICE guidelines recommend that patients currently taking Revlimid who have not received two or more prior therapies continue their current treatment until the patient and doctor consider it appropriate to stop.

In November 2008, NICE opposed funding Revlimid due to its cost.

In response, Celgene, the manufacturer of Revlimid, proposed a cost-sharing plan in which Celgene would cover the cost of treatment beyond 26 cycles (normally two years).

NICE agreed to the cost-sharing plan and released a preliminary announcement in January that recommended Revlimid in combination with dexamethasone be used in relapsed/refractory myeloma patients with two or more prior therapies. The final decision was announced in April.

For more information, see the press release on the NICE Web site.