A cost comparison means Arrowhead accepted a price no higher than a treatment NICE already recommends, and in return announced NHS funding eight days after authorisation. Volanesorsen has been funded under NICE’s 2020 guidance and olezarsen has been appraised for the same patients, so in a population this small the APOC3 drugs now compete under a shared price ceiling.

• Sobi and volanesorsen: the contest is now dosing and eligibility. Plozasiran is injected every three months against monthly for olezarsen, and its recommendation does not carry the high pancreatitis-risk condition NICE attached to volanesorsen in 2020. With price capped by the comparison, those two differences will decide what specialist lipid services prescribe.
• NHS England: the FCS price becomes a reference for severe hypertriglyceridaemia. Arrowhead plans a US filing in severe hypertriglyceridaemia before the end of 2026, after SHASTA-3 and SHASTA-4 cut triglycerides by about 80% in roughly 750 patients, and Sobi won a CHMP opinion for olezarsen in that indication on 16 October. A price set by cost comparison for an ultra-rare group becomes the opening reference when the same drugs seek funding for far more patients.
• Signposts: Scotland, the committee papers and the next filings. Watch for the Scottish Medicines Consortium decision, NICE’s committee papers, which should show the comparator plozasiran was matched against, and when Arrowhead and Sobi file severe hypertriglyceridaemia in the UK.