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NHS patients set to be denied Opdivo and Kadcyla

NICE rejects BMS and Roche cancer treatments

Roche Kadcyla (ado-trastuzumab emtansine) 

NICE has published draft guidance rejecting NHS use of Bristol-Myers Squibb's Opdivo for a form of lung cancer, whilst confirming it is not recommending Roche's breast cancer therapy Kadcyla.

Specifically, PD-1 inhibitor Opdivo (nivolumab) has been turned down as a treatment for locally advanced or metastatic squamous non-small cell lung (NSCLC) whose disease has progressed after prior chemotherapy, with NICE saying it is simply too expensive.

The drug is already being made available to some patients via the Early Access to Medicines Scheme (EAMS), and NICE said that while clearly effective its annual cost of £63,200 (around $95,000) "could not be considered a cost-effective use of NHS resources". 

BMS' general manager in the UK, Johanna Mercier, said the decision is "deeply disappointing for lung cancer patients and for us", adding that the company is "continuing to work with NICE to facilitate access for patients who urgently need it".

Institute of Cancer Research (ICR) chief executive Paul Workman expressed his concern that "innovative drugs are being stifled at the earliest stage before they can show their value", noting that "recently we have seen drug companies setting very high prices for promising immunotherapies, including nivolumab".

"There is no question that this pioneering and innovative treatment improves and extends the life of patients with [NSCLC] but at this price it is very clearly too expensive for the NHS to afford," he added.

ICR and other charities - including the Roy Castle Lung Cancer Foundation - said the decision made it abundantly clear that a new process is needed to make innovative therapies available to patients at realistic prices, particularly with even more expensive combination regimens on the horizon.

NICE is due to deliver a final verdict on Opdivo for squamous NSCLC in February.

Kadycla discounts insufficient

Meanwhile, NICE's final rejection of Kadcyla (ado-trastuzumab emtansine) comes despite Roche offering undisclosed discounts on the drug's £90,000-a-year list price, and after the drug was also turned down by the Scottish Medicines Consortium (SMC).

The company said it had offered NICE the same discount provided to the Cancer Drugs Fund (CDF), which still covers treatment with Kadcyla despite a massive cull of therapies this year. The CDF is due to come to an end in March 2016 however and there is as yet no concrete news on a replacement scheme.

"We are willing to be collaborative and continue discussions with NICE to ensure that Kadcyla remains available to patients in England with advanced breast cancer for the long term," said Roche in a statement.

Article by
Phil Taylor

17th December 2015

From: Sales

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