Access to Dupixent (Dupilumab) Treatment in the UK Explained

Dupulimab is approved for use in the NHS for eosinophilic-associated diseases: Type 2 Inflammatory Asthma and Severe Atopic Dermatitis.

Still, you might have seen that the NICE and SMC applications for Dupixent® (dupilumab) to treat Eosinophilic Oesophagitis (EoE) and chronic rhinosinusitis with nasal polyps in people 12 years of age and older were withdrawn.

If you are wondering what it means and why Dupixent® (dupilumab) is fast becoming available as a treatment for EoE across the world but not in the UK, read on to learn about the policies behind this decision and how our advocacy efforts aim to influence change.

When new treatments are proven effective for more than one condition, this is described as multi-indications. 

In addition, for those with Eosinophilic-Associated Diseases (EADs), the treatment may be effective for multiple conditions (multi-indication) even in one individual, i.e., gut, nasal, lung, or skin, which makes it even more complex.

NICE typically requires a medication to be offered at a single, cost-effective price for all indications. This presents a challenge for multi-indication drugs, like Dupixent® (dupilumab), which may be more costly for one condition than others due to differences in dosage, treatment duration, or clinical requirements. 

NICE's current standard assessment process policies require the lowest negotiated price across all indications, and there is no current standard process for pricing the drug variably to reflect these differences. The lack of flexibility can result in a mismatch between the price and the actual value of a medicine, often leading to it being deemed not cost-effective and, therefore, withdrawn by the manufacturer. This results in the treatment being unavailable to patients through the NHS. 

EOS Network has been working with other stakeholders, such as Cancer 52, Blood Cancer Alliance, Fifth Sense, Sius UK, CMAK and others, to advocate for a review of the NICE process to allow for flexible reimbursement for multi-indication treatments. 

When meeting with other organisations, we discussed the many challenges from both a patient perspective and the current systems and processes within NICE and the clinical setting:

 

While these and many other questions must be answered, this doesn't mean the problem should be ignored.

Advocating For The Eosinophilic Community

We are campaigning for a review of the current processes to standardise the multi-indication treatment reimbursement assessment process.

• Read our consensus statement: Patient Organisation Statement.
• We also submitted our comments to NHS England Commercial Framework Consultation. 

How You Can Support the Campaign:

• Write to Your MP: Help raise awareness by reaching out to your local MP about the need for improved access to multi-indication treatments for eosinophilic diseases.
• Share Your EOS Journey: Volunteer to share your experience with eosinophilic disease and become an EOS voice.
• Volunteer as a Patient Representative: Get involved in future projects by representing the interests and needs of patients like you.

• Submit your thoughts to the NHS 10-Year Plan consultation to help shape the future of healthcare.
• Share this page with people who might find it helpful
• Donate to support our work

---

• EU Approves Dupixent® (dupilumab) as First Treatment for Young Children with EoE
• Dupixent® Effective for Young Children with EoE: Positive Phase 3 Trial Results | NEJM
• FDA Approves Dupixent As EoE Treatment For Children From One to Eleven
• Clinical Guidance for the Use of Dupilumab in Eosinophilic Oesophagitis: A Comprehensive Approach