Cannabidiol (7) – Epidyolex®

Lennox-Gastaut syndrome, ≥ 2 years, combination with clobazam

Characteristics

Start date 01.12.2023 – Marketing authorisation: 19.09.2019
Resolution 16.05.2024
INN Cannabidiol
Brand name Epidyolex®
Pharm. company Dossier: Jazz Pharmaceuticals Germany GmbH
New distributor: JAZZ PHARMACEUTICALS IRELAND LIMITED
G-BA Procedure ID D-1016
ATC code N03AX24 Other antiepileptics (N03AX)
ICD-10 codes (AIS) G40.4Epilepsy with grand mal seizures on awakening
Alpha-ID codes (AIS) I81840Lennox-Gastaut syndrome
ORPHAcodes (AIS) 2382Lennox-Gastaut syndrome
Therapeutic area Nervous system diseases Epilepsy, Epilepsy in children (Dravet syndrome / Lennox-Gastaut syndrome) Orphan (turnover limit)
Reason for procedure Reassessment: Orphan turnover exceeded
Original resolution: Cannabidiol (4) (15.04.2021)
Specialty Bundling ACT change Combination therapy

Therapeutic indication of the resolution

Epidyolex is used as adjunctive therapy for seizures associated with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) in combination with clobazam in patients aged 2 years and older.

Subpopulation Indication Comparator
Patients aged 2 years and older with seizures associated with Lennox-Gastaut syndrome Patient-specific therapy, taking into account the type of seizure occurring, the basic and previous therapy(ies) and any associated side effects, with selection of brivaracetam, bromide, carbamazepine, cenobamate, clobazam, clonazepam, eslicarbazepine, ethosuximide, felbamate, fenfluramine, gabapentin, lacosamide, lamotrigine, levetiracetam, mesuximide, oxcarbazepine, perampanel, phenobarbital, phenytoin, pregabalin, primidone, rufinamide, topiramate, valproic acid, vigabatrin, zonisamide

Studies and Results

No. of studies
(best subpopulation)
0 (Data not accepted)
Study design
(best subpopulation)
Data not accepted (Dossier: H2H vs. non-ACT + no ITC)
ACT change 03.04.2024 – Stellungnahme Fachgesellschaften

  • Clinical trials
    • To assess the additional benefit, the pharmaceutical manufacturer has submitted analyses of studies GWEP1414 and GWEP1423.
    • These are two randomised, controlled, double-blind studies in which cannabidiol was compared with placebo, in each case in addition to ongoing anti-epileptic treatment.

Patients aged 2 years and over with seizures associated with Lennox-Gastaut syndrome

  • For patients aged 2 years and over with seizures associated with Lennox-Gastaut syndrome, the additional benefit is not proven.
  • The additional benefit of cannabidiol compared with the appropriate comparator therapy for patients aged 2 years and over with seizures associated with Lennox-Gastaut syndrome is therefore not proven.
  • In the studies relevant to this benefit assessment, no optimisation of antiepileptic treatment was planned for patients in the comparator arm.
  • Although the included patients experienced regular epileptic seizures, the existing anti-epileptic medication in the comparator arm was supplemented only by placebo and was therefore continued unchanged.
  • The appropriate comparator therapy was therefore not implemented in the studies submitted for the benefit assessment.
  • Overall review
    • In the overall review, there are no suitable data available for comparing cannabidiol with the appropriate comparator therapy. Consequently, additional benefit from cannabidiol is not proven for patients aged 2 years and over with seizures associated with Lennox-Gastaut syndrome.

Courtesy translation only, please refer to the German original.

Associated procedures

Cannabidiol (6) Epidyolex® Jazz Pharmaceuticals Germany GmbH Nervous system diseases Dravet syndrome, ≥ 2 years, combination with clobazam 0
500–2,900
100% additional benefit not proven Orphan (turnover limit) repealed
Cannabidiol (7) Epidyolex® Jazz Pharmaceuticals Germany GmbH Nervous system diseases Lennox-Gastaut syndrome, ≥ 2 years, combination with clobazam 1,700–22,700 100% additional benefit not proven Orphan (turnover limit)
Cannabidiol (8) Epidyolex® Jazz Pharmaceuticals Germany GmbH Other diseases Seizures associated with tuberous sclerosis, ≥ 2 years 200–2,700 100% additional benefit not proven Orphan (turnover limit)
Cannabidiol (5) Epidyolex® GW Pharmaceuticals plc Other diseases Seizures in Tuberous Sclerosis, ≥ 2 years 0
500–2,700
100% Hint for non-quantifiable additional benefit Orphan repealed
Cannabidiol (4) Epidyolex® GW Pharmaceuticals plc Nervous system diseases Lennox-Gastaut syndrome, ≥ 2 years, combination with clobazam 0
2,600–22,700
100% Hint for considerable additional benefit Orphan repealed
Cannabidiol (3) Epidyolex® GW Pharmaceuticals plc Nervous system diseases Dravet syndrome, ≥ 2 years, combination with clobazam 0
1,100–3,100
100% Hint for considerable additional benefit Orphan repealed
Cannabidiol (1) Epidyolex® GW Pharmaceuticals plc Nervous system diseases Dravet syndrome, ≥ 2 years, combination with clobazam 0
1,100–3,100
100% Hint for non-quantifiable additional benefit Orphan repealed
Cannabidiol (2) Epidyolex® GW Pharmaceuticals plc Nervous system diseases Lennox-Gastaut syndrome, ≥ 2 years, combination with clobazam 0
2,600–22,700
100% Hint for non-quantifiable additional benefit Orphan repealed


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