The National Institute for Health and Care Excellence (NICE) has recommended that the NHS should pay for the cannabis-based medical product Epidyolex (GW Pharmaceuticals) as an adjunct therapy for two severe forms of epilepsy.
The recommendation was made in technology appraisal guidance published on 18 December 2019, and follows the findings of NICE’s final appraisal document on the treatment, which was published in November 2019.
Epidyolex is a 100mg/mL oral solution of cannabidiol licensed for use as an adjunct therapy for seizures associated with Lennox-Gastaut syndrome and Dravet syndrome. It is to be used alongside clobazam.
In caveats to the recommendation, NICE said that cannabidiol is only recommended for these patients if the frequency of seizures is checked every six months. If, after six months of treatment, the frequency of seizures has not reduced by at least 30%, cannabidiol should be stopped, the guidance says.
The recommendation is also subject to the manufacturer providing cannabidiol according to a discount patient access scheme set out in a commercial agreement. This makes the drug available to the NHS at a discount, which is not being published owing to commercial confidentiality.
Under the guidance, cannabidiol will not be offered as a first-line treatment, as it is to be accompanied by clobazam — which is currently used as an adjunct where two other anti-epileptic drugs have failed to adequately control seizures.
The guidance says the committee agreed that it was “appropriate” to put cannabidiol with clobazam in the treatment pathway.