NICE (UK) negative for Opzelura (ruxolitinib cream) for treating non-segmental vitiligo in people 12 years and over – Incyte

NICE (UK): Ruxolitinib cream is not recommended, within its marketing authorisation, for treating non-segmental vitiligo with facial involvement in people 12 years and over. This recommendation is not intended to affect treatment with ruxolitinib cream that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop. For young people (aged 12 to 17 years), this decision may be made jointly by the healthcare professional, the young person, and their parents or carers.

Why the committee made these recommendations: There are no licensed treatments for non-segmental vitiligo. There are unlicensed treatments used with the aim of restoring the skin’s colour (repigmentation). These are corticosteroids and calcineurin inhibitors that are used on the skin. After trying these, some people have treatment with light (phototherapy). Ruxolitinib cream is a licensed treatment for non-segmental vitiligo that affects the face in people 12 years and over. Clinical trial evidence shows that ruxolitinib cream increases repigmentation and reduces how noticeable vitiligo patches are compared with a cream that does not contain any of the drug. But an indirect comparison is too uncertain to show how well ruxolitinib cream works compared with phototherapy. The cost-effectiveness estimates are very uncertain because of limitations in the economic model, which does not reflect how vitiligo is treated in the NHS. It is also uncertain whether treatment with ruxolitinib cream would improve people’s quality of life. The most likely cost-effectiveness estimate is higher than what NICE considers an acceptable use of NHS resources despite having considered the impact of potential uncaptured benefits in the model. So, ruxolitinib cream is not recommended.