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Bayer's Nexavar backed by NICE for liver cancer

The drug is the only approved first-line treatment for advanced HCC

Nexavar

Bayer's Nexavar will be available for routine use for liver cancer by NHS England clinics - and not just via the Cancer Drugs Fund - after a change of heart by the National Institute for Health and Care Excellence (NICE).

A final appraisal from the clinical and cost-effectiveness watchdog backs Nexavar (sorafenib) for use on NHS England for the treatment of patients with "advanced hepatocellular carcinoma (HCC) who have a Child-Pugh grade A liver impairment and who have failed or are unsuitable for surgical or loco-regional therapies".

At the list price, the twice-daily oral drug costs £128 per day per patient, but Bayer has agreed a drug at an undisclosed discount to NHS England. It is the first and only approved first-line pharmacological treatment option for patients with advanced HCC and is estimated to extend life by at least three months.

NICE has rejected Nexavar for liver cancer multiple times - the last being in December 2016 when it concluded that the drug did not provide value for money for the NHS and so should stay within the CDF.

The news has been welcomed by patient groups. Andrew Langford, chief executive of the British Liver Trust, said: "Treatment options for patients with advanced liver cancer have been very limited, but this decision will make sorafenib…more easily available and bring greater long-term certainty for patients."

"Evidence shows that outcomes for people with advanced liver cancer are particularly poor, so any increase in length of life is very important," he added.

The re-evaluation is part of an ongoing process - now three quarters complete - to review drugs on the CDF and see if they should be upgraded to routine NHS use.

Out of 24 treatments under scrutiny, 18 have been approved in either final or draft guidance. The majority of these drugs are now available for routine use on the NHS, according to NICE.

Amanda Cunnington, head of patient access at Bayer UK, said the company recently submitted its new HCC drug Stivarga (regorafenib) for review by NICE and the Scottish Medicines Consortium (SMC) "with the hope to also provide the first approved second-line treatment option for patients with HCC, who have previously been treated with sorafenib".

Article by
Phil Taylor

10th August 2017

From: Regulatory

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