Evolocumab – NICE guidelines – a reply

On 17th May 2017, I received a reply to the letter set out in this post.

Dear Zoe

Thank you for contacting the National Institute for Health and Care Excellence (NICE).

“I am very sorry for the length of time taken to respond to you. I have needed to liaise with colleagues in the technology appraisals team about the concerns you’ve raised regarding our appraisal of evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia (TA394).

“At the time the evolocumab appraisal was published (June 2016), we said the guidance will next be considered for update “after February 2018, when the results of the FOURIER trial are available”. (This text can be found on the overview page for this guidance).

“We understand that the trial you are referring to is the FOURIER trial.

“With this in mind, we are considering if there is availability in our review proposal work programme to bring the scheduled review forward. Our website will be updated with further details about this when the information becomes available.

“In the meantime, our appraisal of evolocumab (TA394) contains our current guidance regarding when evolocumab is recommended as an option on the NHS for treating primary hypercholesterolaemia or mixed dyslipidaemia.”


I replied:

Please can the evidence that I sent you (here) be taken into account when the review takes place. Meanwhile you are now aware that 1) there is no evidence of benefit for evolocumab in the circumstances in which NICE recommends it and 2) the cost of evolocumab fails any test of value for money.”


NICE replied:

The information will be considered when we review the need for the guidance to be updated.”


Watch this space!


2 thoughts on “Evolocumab – NICE guidelines – a reply

  • avatar
    July 3, 2017 at 5:21 pm

    IOW “we need bigger bribes before we recommend it”

    I’m only half kidding . . .

    • avatar
      July 19, 2017 at 12:07 am

      Fantastic work! I was recently bulldozed by my cardiologist to try a shot of Repatha. I took it, as my wife was scared shitless by the doctor”, but now I see it was a mistake. A mistake I will never make again. My cost for a shot of Repatha would be 1,100USD.


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