The UK’s National Institute for Health and Care Excellence (NICE) last week determined that the high cost of Sanofi’s cancer drug Zaltrap meant it was unsuitable for use on the NHS to treat advanced bowel cancer.
NICE, which assesses the cost-effectiveness of products for NHS use, released draft guidance recommending against the use of Zaltrap (aflibercept) in the treatment of people with metastatic colorectal cancer that is resistant to or has progressed after previous treatment with an oxaliplatin-based therapy.
The negative recommendation is despite Sanofi agreeing to an undisclosed patient access scheme, which effectively means the pharma company would cover part of the drug’s cost.
This wasn’t good enough for NICE’s independent committee it seems, which acknowledged Zaltrap was clinically effective, but said the plausible cost per Quality Adjusted Life Year (QALY) was more than £60,000 – much higher than NICE’s standard limit of £30,000.
“We have already recommended six treatments for various stages of colorectal cancer and are disappointed not to be able to add aflibercept to the list of treatments for this stage of the disease,” said Sir Andrew Dillon, chief executive of NICE.
“However, we have to be confident that the benefits that drugs offer patients really do justify what the NHS will have to pay for them.”
Drugs already recommended by NICE for colorectal cancer include irinotecan, fluorouracil and Roche’s Xeloda (capecitabine).
However, there is also a growing list of drugs rejected for use in colorectal by NICE, including Roche’s Avastin (bevacizumab), Merck KGaA’s Erbitux (cetuximab) and Amgen’s Vectibix (panitumumab), all of which have faced negative recommendations for use in metastatic colorectal cancer.
As it stands, Zaltrap would join these drugs, although there is now a consultation period during which Sanofi can argue its case for Zaltrap’s recommendation ahead of further guidance.