NICE recommends Novartis kidney cancer drug

England’s cost-effectiveness body has recommended Novartis’ kidney cancer drug, Afinitor (everolimus) for regular National Health Service funding, as it reassesses drugs that were reimbursed by the old Cancer Drugs Fund (CDF).

The CDF had been paying for Afinitor after NICE rejected it back in April 2011 – but Novartis has submitted a further discount that was included in this latest cost-effectiveness analysis.

In the final guidance NICE considered the new price, as well as the limited treatments available to patients with advanced renal cell carcinoma.

A year’s treatment with Afinitor costs £32,076 per patients, but Novartis has agreed a commercially confidential discount.

NICE calculated that treatment costs around £50,000 per Quality Adjusted Life Year gained – above its usual upper threshold of £30,000, but acceptable to NICE under arrangements giving greater flexibility for end-of-life drugs.

There are only around 4,000 eligible patients in England and Wales, and life expectancy with best supportive care is unlikely to be greater than 24 months, and potentially as low as five months.

Afinitor could increase survival by more than three months with best supportive care, according to NICE.

Treatment for kidney cancer has moved on since NICE rejected Afinitor: the cost-effectiveness body has since recommended Pfizer’s Inlyta (axitinib), a tyrosine kinase inhibitor, and Bristol-Myers Squibb’s Opdivo (nivolumab) anti-PD-1 immunotherapy is also indicated for previously treated advanced renal cell carcinoma.

Nevertheless clinical experts said that Afinitor was still a valuable option for patients.

Professor Carole Longson, director of the Centre for Health Technology Evaluation at NICE, said: “Advanced renal cell carcinoma is a relatively rare cancer and unfortunately there are limited treatment options for this condition.

“The company engaged positively with the process of reconsidering drugs in the CDF, demonstrated their drug to be cost effective, and as such we were pleased to make a positive recommendation. This decision, when implemented, will allow funding in the CDF to be freed up, which can then be spent on other new and innovative cancer treatments.

“Our decision means that many patients can feel reassured that they can now get NHS access to everolimus."