Methylnaltrexone: where the agencies disagree
This page collects every recorded health technology assessment decision for one molecule across the agencies in our archive, and compares them. The comparison is the point: each agency publishes its own verdict, none publishes how that verdict sits against the others.
What the record shows
AOTMIT (Poland), HAS (France) and PHARMAC (New Zealand), among others, recommended or restricted methylnaltrexone, while AWMSG (Wales) did not recommend it.
Where methylnaltrexone met resistance it was usually narrowed rather than refused: 3 of 8 decisive outcomes were recommendations with restrictions, against 1 outright refusal.
The file has been open for more than a decade: 16.5 years separate the first record, 13 Aug 2008 at AWMSG (Wales), from the most recent, 12 Feb 2025 at HAS (France).
PHARMAC (New Zealand) changed its position: recommended on 11 Aug 2016, restricted by 26 Jun 2023.
No assessment is on file from PBAC (Australia), CIPM (Spain) and G-BA (Germany), each among the eight highest-volume agencies here.
Not every gap is a refusal: for methylnaltrexone, 2 were withdrawn or terminated before a decision — an outcome set by the company rather than the assessor.
The file is active: 2 of 13 records date from 2023 or later.
5 distinct indication wordings are recorded for methylnaltrexone by the agencies that label one in English (AWMSG, NICE and SMC).
AWMSG (Wales) was first to assess methylnaltrexone, on 13 Aug 2008; AOTMIT (Poland) did not open a file until 5 Dec 2019 — an unusually long tail of 11.3 years between the earliest and latest system to look at it.
The record arrives in waves: 3 separate years each carry two or more decisions, spread across 9 years in total.
Restriction is doing real work here: 3 of 8 decisive outcomes narrowed methylnaltrexone to a subgroup rather than accepting or refusing it outright, at AOTMIT (Poland), PHARMAC (New Zealand) and SMC (Scotland).
4 of the 7 agencies here assessed methylnaltrexone more than once, HAS (France) most often at 4 entries — repeat review is the norm for this molecule rather than the exception.
7 of the 18 agencies in this archive hold a record for methylnaltrexone.
The full ledger for methylnaltrexone reads 4 recommended, 3 restricted, 2 terminated and 2 other, with 2 in other categories.
Decisions on file
| Agency | Date | Indication as recorded | Outcome | Source |
|---|---|---|---|---|
| HAS (France) | 12 Feb 2025 | Listing (Transparency Committee) | SMR substantial · ASMR V | source |
| PHARMAC (New Zealand) | 26 Jun 2023 | Opioid-induced constipation in hospitalised patients outside of palliative care | PTAC advice: Low · decision reached | source |
| AOTMIT (Poland) | 5 Dec 2019 | Relistor reimbursement recommendation | recommended conditionally | source |
| NICE (England) | 23 Aug 2017 | NICE TA468 | terminated appraisal | source |
| AWMSG (Wales) | 13 Oct 2015 | In the absence of a submission from the holder of the marketing authorisation, methylnaltrexone bromide (Relistor®) cann… | not endorsed (non-submission) | source |
8 further decisions for methylnaltrexone, across 6 agencies, are not shown here. They link to 5 further source documents.
Related molecules
- naldemedine — same ATC class A06A — Laxatives
- prucalopride — same ATC class A06A — Laxatives
- naloxegol — same ATC class A06A — Laxatives
- vosoritide — also decided by HAS in 2025Q1
- methotrexate — also decided by HAS in 2025Q1
- ribociclib — also decided by HAS in 2025Q1
Coverage: 13 decisions for methylnaltrexone from 7 agencies, 2008 to 2025. Data to 7 Sep 2026. ATC class A06A — Laxatives. How this page is produced. Compiled by Altima Partners; queries: sales@altimapartners.co.uk.