National Institute for Health and Clinical Excellence (NICE)
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First NICE-recommended treatment for Parkinson’s set to benefit hundreds

Around 900 adults with advanced Parkinson’s are set to benefit from new treatment foslevodopa–foscarbidopa after NICE approved it for NHS use in final draft guidance published today (26 October 2023)

NICE has recommended foslevodopa–foscarbidopa (also called Produodopa and made by AbbVie) as an option for treating advanced Parkinson’s, a progressive disorder that affects the nervous system and the parts of the body controlled by the nerves.

The treatment is delivered by an infusion pump, which gives the medicine over 24 hours. The device is small, completely portable and can be refilled at home, which is convenient for patients and their carers, and helps people manage their symptoms effectively.

It works by releasing the drugs foslevodopa and foscarbidopa into the body where foslevodopa is turned into the chemical dopamine, which is used to transmit messages between the parts of the brain and nerves that control movement. Taking foslevodopa with foscarbidopa increases the availability of foslevodopa in the brain.

Oral treatment with levodopa and carbidopa is the standard initial treatment for Parkinson’s, but as the disease progresses other medicines may be added. Non-oral treatments that may be used in advanced Parkinson’s that is responsive to levodopa include apomorphine (a drug given as an injection to act like dopamine to stimulate nerve cells), deep brain stimulation through surgery or levodopa–carbidopa intestinal gel.

As a potential new option for advanced Parkinson’s, the company asked for foslevodopa–foscarbidopa to be considered only for people who cannot have apomorphine or deep brain stimulation surgery, or for when these treatments no longer control symptoms. So foslevodopa–foscarbidopa was only considered as an alternative to standard oral treatment and levodopa–carbidopa intestinal gel.

This is the first technology appraisal from NICE to look at a treatment for Parkinson’s. NICE has previously published clinical guidelines and medtech innovation briefings on Parkinson’s.

Helen Knight, director of medicines evaluation at NICE, said: “Foslevodopa–foscarbidopa represents an important new treatment for people with advanced Parkinson’s, providing an easy-to-use option that can help them manage their symptoms more reliably and effectively.

“This is the first time NICE has approved a treatment for Parkinson’s and comes after NICE was able to work with the company to address the issues that had initially prevented a positive recommendation. We are determined to get the best care to patients fast and ensure value for the taxpayer.”

Read the draft guidance on foslevodopa–foscarbidopa for advanced Parkinson's here

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