NHS England will not routinely commission selexipag for PAH

Actelion Pharmaceuticals UK & Ireland have announced that an NHS England ruling means patients in England who have a life-limiting condition must continue to wait for access to a new twice daily tablet for pulmonary arterial hypertension (PAH).

PAH is a devastating disease that causes an increase in blood pressure in the blood vessels between the right side of heart and lungs. The disease typically affects patients in the prime of their life, with disproportionately more women than men affected.

The decision will delay access to Uptravi® (selexipag)▼as a combination treatment for PAH in adult patients with one of the more severe forms of the disease who are insufficiently controlled on oral treatment with two other classes of PAH medicines. This ruling will create a disparity in access to selexipag throughout the UK, with patients in Scotland and Wales already having access.

“Today’s announcement will be distressing news for PAH patients ANDtheir families across England”

Current therapies which also target the prostacyclin pathway, whilst effective, can be difficult for patients to administer. For example, inhaled iloprost requires the use of a nebuliser up to nine times a day which can be difficult for patients to prepare and take. Due to the nature of these treatments, over 90% of FC III PAH patients do not currently receive prostanoid treatment before they die.

Selexipag is an innovative, oral treatment that specifically targets the prostacyclin pathway, a major disease pathway involved in the development of PAH. The GRIPHON trial found that selexipag was significantly better than placebo as measured by a composite primary outcome of complications related to PAH or death.

Dr John Wort, Clinical Lead for Pulmonary Hypertension at the Royal Brompton & Harefield NHS Trust said,“today’s announcement will be distressing news for PAH patients, their families and PH clinicians across England. Selexipag is a step-change in the treatment of these patients as it is the first oral medicine targeting the important prostacyclin pathway, which offers hope for those who have had insufficient benefit from existing oral treatments. It is therefore extremely disappointing that PH clinicians will not be able to offer this treatment to patients.”

Dr Iain Armstrong, Chair, Pulmonary Hypertension Association UK added, “As a patient organisation we are bitterly disappointed with the decision not to fund selexipag, a treatment that Welsh and Scottish patients both have access to on the NHS. An urgent review is needed on decisions regarding new therapies available for PH currently blocked or deferred by national funders. As a PH community we don’t ask for much; we just want the same equality and access to treatment as other disease areas like cancer.”