National Institute for Health and Clinical Excellence (NICE)
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NICE recommends lubiprostone to treat long-term, painful constipation

The National Institute for Health and Care Excellence (NICE) has recommended lubiprostone (Amitiza, Sucampo Pharma Europe) as a treatment option for chronic idiopathic constipation in adults.

This type of constipation is very common, affecting people over a prolonged period of time. The cause of chronic idiopathic constipation is often unknown. Intense abdominal pain is a common symptom and severe cases can affect a person’s physical and mental health.

Lubiprostone works differently to current treatments; it relieves symptoms by increasing the sliminess of the bowel lining. The new NICE guidance is for adults who have tried at least 2 laxatives at the highest tolerated recommended doses for at least 6 months, but who have not seen an improvement in their symptoms.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: “Chronic idiopathic constipation can be very distressing. Symptoms go beyond difficulty going to the lavatory and can be embarrassing for the person affected. It is a painful condition and those who suffer from it can experience a decreased quality of life.

The guidance has been published on the NICE website. The NHS now has a legal duty to begin funding the treatment for eligible patients within the next 3 months.

Notes to Editors

A copy of the final recommendations can be found on the NICE website.

  • Lubiprostone is recommended as an option for treating chronic idiopathic constipation, that is, for adults in whom treatment with at least 2 laxatives from different classes, at the highest tolerated recommended doses for at least 6 months, has failed to provide adequate relief and for whom invasive treatment for constipation is being considered.
  • Lubiprostone has a different mechanism of action to prucalopride, as it activates chloride channels in gastrointestinal epithelial cells, relieving symptoms of chronic constipation by improving intestinal secretion.
  • The manufacturer reported a cost of £53.48 for the 56‑capsule pack of lubiprostone and a cost of £29.68 for the 28‑capsule pack. The unit cost of prucalopride was based on British national formulary (BNF) prices.
  • Lubiprostone was associated with an ICER of £64,464 per QALY gained compared with placebo at an incremental cost of £165, and an incremental QALY gain of 0.0026.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

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