Policy number: SRP 021
Policy name: Bone Morphogenic Protein (BMP)
Status: Individual Funding Approval
Effective date: 30 April 2024
Next review date: 30 April 2026
Mid and South Essex ICB commission use of BMP on a restricted basis and only in line with the East of England Priorities Advisory Committee (PAC) for use of BMP.
There is currently one BMP product available in the UK, dibotermin alfa (rhBMP-2) (InductOs®), which is produced by recombinant technology.
Eptotermin alfa (rhBMP-7) (Osigraft®) was withdrawn from the EU market in December 2015 at the request of the marketing authorization holder.
Acute tibial fractures with Grade 111B fractures (i.e. more severe cases)
Dibotermin alfa is recommended as an adjunct to standard care using open fracture reduction and intramedullary nail fixation in adult patients in whom there is a substantial risk of non-union. It is restricted to patients treated with uncemented intramedullary nails.
Treatment is restricted by named consultants for use in tibial, ulnar, radial, humoral, femoral and clavicular non-union.
The ICB does not commission BMP for:
- Skeletal immature individuals defined as those who can reasonably be expected to not have fusion of the long bone epiphyses. In other words, they are still growing (variant; normally in girls below 16 years and in boys below 19 years. (To be individually confirmed.)
- Repeat doses or sequential use of BMPs due to the possible development of antibody production.
Funding for patients not meeting the above criteria will only be granted in exceptional clinical circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Find out more information on applying for funding in exceptional clinical circumstances
Reference: Dibotermin alfa for the management of acute tibial fractures in adults PAC