Solriamfetol for treating excessive daytime sleepiness caused by obstructive sleep apnoea: Appraisal consultation document
DRAFT guidance does not recommend solriamfetol to improve wakefulness and reduce excessive daytime sleepiness in adults with obstructive sleep apnoea whose sleepiness has not been satisfactorily treated by primary obstructive sleep apnoea therapy, such as CPAP.
Source:
National Institute for Health and Care Excellence
SPS commentary:
The Appraisal committee noted that the clinical trial evidence shows that solriamfetol added to a primary obstructive sleep apnoea therapy (standard care) reduces excessive daytime sleepiness compared with standard care alone, but did not show a difference in quality of life, though this was uncertain because of the way that quality of life was assessed in the trial. No evidence was presented on solriamfetol alone, although it is an option in the full marketing authorisation for people who cannot use CPAP. There were concerns about how the trial data have been modelled to take account of a potential placebo effect in the standard care group, and uncertainty about the assumptions around the doses used in clinical practice. Therefore, the cost-effectiveness estimates for solriamfetol with standard care compared with standard care alone are uncertain. They are also likely to be higher than what NICE normally considers an acceptable use of NHS resources.