The UK’s National Institute for Health and Care Excellence (NICE) has published contrasting guidance for the NHS use of two new cancer drugs.
The cost-effectiveness agency issued draft guidance giving the green light to Janssen’s Velcade in the treatment of certain patients with multiple myeloma in England and Wales.
However, the news was less positive for Bayer, which received draft guidance denying use of its Xofigo for the treatment of adults with hormone relapsed prostate cancer, symptomatic bone metastases and no known visceral metastases.
The positive recommendation for Velcade (bortezomib) covers its use in combination with the steroid dexamethasone, or with dexamethasone and thalidomide, for the induction treatment of adult patients with multiple myeloma who are yet to be treated.
These patients should also be eligible for high-dose chemotherapy with haematopoietic stem cell transplantation.
The draft guidance overturns a previous negative recommendation from NICE in this indication, with the agency claiming it did not have information to fully assess whether the drug was a cost-effective use of NHS resources.
It seems Janssen has now addressed these concerns, and, if given a final recommendation, will be able to add to Velcade’s existing NICE indications, which include its use in combination with an alkylating agent and a corticosteroid in multiple myeloma patients.
Eric Low, Myeloma UK’s chief executive, said: “Today’s decision by NICE to approve Velcade induction treatment is fantastic news for myeloma patients in England and Wales. Clinicians can now choose between at least three options enabling them to tailor treatment to best suit the clinical situation at hand and also to reflect patient preference.”
News was less positive for prostate cancer patients, however, with Bayer unable to convince NICE that Xofigo (radium-223 dichloride) was a cost-effective use of resources.
The agency’s main issue was the Bayer did not provide data that compared Xofigo to other recommended treatments, namely the chemotherapy docetaxel and Janssen’s Zytiga (abiraterone).
Instead, Bayer just supplied data from trials comparing the drug to placebo, meaning NICE was unable to carry out an effective assessment of the drug’s value.
Bayer will have a chance to respond during a consultation period, after which further guidance will be published.