Crowding in the multiple sclerosis space hasn’t stopped new Roche drug Ocrevus from making a splash. But that competition is making it tough for the Swiss drugmaker to snag reimbursement in England.

Thursday, the National Institute for Health and Care Excellence (NICE) shot down (PDF) the drug in relapsing forms of MS, and its draft guidance specifically states—up front—that the agency already backs eight other drugs for the disease.

And since there’s “no evidence directly comparing” Ocrevus with most of those older drugs, and it’s “uncertain” whether the pricey Roche drug can top them at slowing disease progression, the cost watchdog isn’t going to spring for it—at least, not for now.

“Ocrelizumab at its current price is not cost effective” compared with beta interferons, Biogen’s Tecfidera, Teva’s Copaxone and Sanofi’s Aubagio, the guidance reads.

NICE, of course, is famous for changing its mind if the price is right, and Roche has plenty of experience with that process. Ocrevus is just the latest in a long line of its therapies to run into reimbursement hurdles, and frustrations with NICE—particularly over Roche’s cancer treatments—have prompted ire from its CEO in the past.

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That’s not to say Roche hasn’t already come down from its £4,790-per-300 mg vial list price. It’s already served up a confidential discount—just not one large enough to sway the gatekeeper. And if its U.S. pricing strategy is any indication, Roche may be willing to go lower; there, it priced Ocrevus at a 25% discount to the competition, spurring quick uptake and major sales early on.

Ocrevus made waves in the multiple sclerosis field with stellar phase 3 data, becoming the first drug to put up a positive showing in primary progressive forms of the disease. Industry watchers predicted its arrival would pressure an already squeezed field that’s only set to become even more competitive when generics of Novartis’ Gilenya arrive.

Roche, meanwhile, is counting on big things from Ocrevus as its older cancer blockbusters come under biosimilar attack. All eyes are on the newcomer, as well as the pharma giant’s Tecentriq, an immuno-oncology product that’s jockeying for position with Bristol-Myers Squibb’s Opdivo, Merck’s Keytruda and more.