Novartis's multiple sclerosis pill Gilenya failed for a second time to gain the backing of the UK's health-cost agency, denting the company's ambitions to turn the drug into a blockbuster.

Novartis failed to show that Gilenya would be cost effective compared with existing options available even after the drugmaker proposed a discount, the National Institute for Health and Clinical Excellence said in a statement today.

NICE said in August the annual cost for the medicine, also known as fingolimod, was about £19,196.

Gilenya, approved in Europe in March as the first oral treatment for MS, is among the products that Basel, Switzerland- based Novartis is counting on to fuel sales growth as patents start to expire on the company's best-selling treatments, including the hypertension pill Diovan.

"While Novartis submitted evidence that shows fingolimod can reduce relapses, our independent committee has not been convinced that it is a cost effective treatment option," Andrew Dillon, chief executive of NICE, said in the statement. NICE advises the state-run National Health Service on which medicines represent value for money as the UK government works to save as much as £20 billion a year on medical expenses.

Novartis "remains committed to engaging with NICE with the goal of ensuring that appropriate patients will have access to Gilenya," the company said in an e-mailed statement. "This is not the final guidance from NICE."

The company declined to disclose details on the discount it proposed to NICE.