National Institute for Health and Clinical Excellence (NICE)
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NICE approves sickle cell device that could save NHS £13m per year

NICE has recommended a new device for managing sickle cell disease that makes treatment for the condition easier and quicker, and could save the NHS around £13 million per year.

In latest guidance, NICE recommends the Spectra Optia Apheresis System for red blood exchange in patients with sickle cell disease who require regular transfusion.

Sickle cell disease is an inherited disorder which leads to red blood cells developing abnormally. While normal red blood cells are flexible and disc-shaped, in those with sickle cell disease the cells become crescent shaped and rigid.

Common symptoms may include intense pain and severe anaemia, and the condition can cause damage to major organs and infections, leading to life-threatening complications.

In the UK, around 240,000 people are thought to carry the genetic trait that leads to the disorder, and 12,500-15,000 people carry the disease. Though the condition can affect people from any ethnic group, it is more prevalent among people of African and African-Caribbean descent.

One effective treatment for sickle cell disease is blood transfusion which can treat and prevent complications that relate to the disease.

However the treatment can be painful, can often take a long time to carry out, and can lead to the patient gaining excessive levels of iron which they are unable to excrete – known as iron overload.

NICE guidance on the Spectra Optia says the system is effective for blood transfusion in managing sickle cell disease. It can lead to less numbers of treatments that last for a shorter period of time. In addition, the system is effective in treating patients who are already iron overloaded, since it aims to aid no additional iron during the process

The device is also likely to result in significant cost savings, estimated at £18,100 per patient per year, potentially saving the NHS in England £12.9 million each year.

The savings depend on the iron overload status of the patient, and are more likely to be achieved if devices already owned by the NHS can be used to treat sickle cell disease.

Value to patients is “absolutely immeasurable”

Professor Carole Longson MBE, Director of the NICE Centre for Health Technology Evaluation, said: “Sickle cell can be a painful, debilitating condition, potentially leading to major organ damage. Treatments are very limited, so this new guidance recommends a novel option which is very good news for patients as it makes the red blood cell exchange process faster and less frequent. 

“The device could save the NHS in England an estimated £13 million each year – around £18,000 per patient – with the size of the saving depending on the patient’s condition and the equipment already owned by the NHS.

Kelly Samuel, who has sickle cell disease and is being treated with the Spectra Optia system, and who also contributed to the development of the NICE guidance said: “Without Spectra Optia treatment my health and quality of life would be radically diminished. My Sickle Cell Disease would dominate my existence with pain, weakness, and ultimately death.

“This treatment has been a real lifeline - nowadays my life isn’t constantly overshadowed by the grim prospect of spending weeks, and sometimes months in a hospital bed. Thankfully, I have regular access to the treatment, which I only need to have 5 or 6 times a year instead of every month with the old treatment.  I now have the strength to enjoy my work, my children, family and friends and study for a postgraduate degree.

“This NICE guideline can encourage best practice in managing sickle cell throughout the NHS – its value to patients is absolutely immeasurable.”

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