NICE backs Ibrance for breast cancer via Cancer Drugs Fund


Pfizer’s Ibrance has been approved for use by the NHS in England as a second-line treatment for advanced breast cancer after hormonal therapy, catching up with rival drugs in the class.

The decision by NICE means that CDK4/6 inhibitor Ibrance (palbociclib) will be made available for patients via the Cancer Drugs Fund (CDF), which covers the cost of cancer drugs until confirmatory data is available.

Ibrance will now be an option in combination with anti-oestrogen drug fulvestrant for the approximately 3,200 women in England living with advanced hormone receptor-positive, HER2-negative breast cancer who have already had earlier rounds of hormone therapy.

The Scottish Medicines Consortium (SMC) backed routine use of Pfizer’s drug for the same indication in July, making the drug an option for around 400 eligible women north of the border.

This stage of breast cancer is considered incurable and treatment options are limited, with only 15% of patients living beyond five years.

NICE has previously backed first-line use of Ibrance in combination with aromatase inhibitor drugs in HR+/HER2- breast cancer, after Pfizer reduced the price of the drug in the wake of an initial rejection by the cost-effectiveness watchdog.

Two other CDK4/6 inhibitors – Novartis’ Kisqali (ribociclib) and Eli Lilly’s Verzenios (abemaciclib) – have already been approved by NICE for both first- and second-line use in advanced HR+/HER2- breast cancer, which is the most common type of breast cancer accounting for more than 60% of all diagnoses.

As with Ibrance, availability for previously-treated patients is via the CDF while additional evidence of efficacy is gathered.

Evidence to back up Ibrance use in second-line breast cancer comes from the PALOMA-3 trial, which showed the drug was able to increase the time before the condition progresses, allowing patients additional months of life, and could also delay the need for chemotherapy with its associated side effects.

“This outcome marks a significant milestone for the secondary breast cancer community,” said Dr Olivia Ashman, oncology medical director for Pfizer UK.  

“We know how important it is for women to have access to treatment options that can delay the progression of their disease and help them live a normal life for longer, and we are delighted that through the CDF this option will be available,” she added.

Ibrance was the first CDK4/6 inhibitor to reach the market and has become a big brand for Pfizer, with sales reaching around $4 billion last year.

EvaluatePharma analysts have previously predicted it could go as high as $6 billion in 2022, staying ahead of its rivals with Novartis and Lilly’s drugs jostling for second place in the market with sales of around $1.6 billion apiece in that year.