NICE has approved the first re-appraised drug from the now-defunct Cancer Drugs Fund (CDF) – but Pfizer has warned that companies cannot keep cutting prices in order to gain favour.
The manufacturer’s Bosulif, which previously was only available via the CDF, has been recommended by the watchdog to treat NHS patients with chronic myeloid leukaemia (CML) who have not responded to first- and second-line treatment or who experience severe side effects.
However, Pfizer had to offer a further discount to get its drug on the list and David Montgomery, medical director of Pfizer Oncology UK, said: “It is not sustainable to ask companies to continuously drop the price for these medicines and it will impact our ability to make further medical progress if we do so.”
He urged the government and NHS to “work with us to find a suitable approach to ensure patients will benefit from the many advances coming through the industry pipeline when they need them”.
Professor Carole Longson, director of the Centre for Health Technology Evaluation at NICE, praised Pfizer for engaging “positively” with the process.
“[The company] demonstrated that their drug can be cost effective, which resulted in a positive recommendation. This decision, when implemented, frees up funding in the CDF which can be spent on other new and innovative cancer treatments,” she said.
The revised discount – as well as the limited treatment options for patients – were crucial in NICE’s decision to recommend in its final draft guidance.
Montgomery added: “We are pleased NICE recognises that bosutinib is an efficacious and cost effective treatment. However, all too often UK patients don’t get access to the modern medicines they need because of the way the health system values and assess medicines. To keep up with advances in the development of more targeted medicines, the health system needs a different approach.”
Bosulif (bosutinib) was one of 25 medicines across 42 oncology indications that NHS England listed for re-evaluation on the CDF in 2014.
It is an oral, once-daily, tyrosine kinase inhibitor used to treat people with CML that have the abnormal Philadelphia chromosome which can lead to the overproduction of white blood cells.
The therapy limits cancer cell growth by inhibiting the Abl and Src signalling pathways and was approved in 2013 for the treatment of patients with chronic, accelerated or blast phases of the disease.