NICE recommends Eisai's kidney cancer combination

NICE has recommended Eisai’s Kisplyx (lenvatinib) in combination with Novartis’ Afinitor (everolimus) in kidney cancer after the company further dropped its price.

Eisai has had a fraught relationship with NICE, with regional chief Gary Hendler last month calling for it to be reformed after a series of setbacks.

Nevertheless, Eisai convinced NICE to recommend Kisplyx in this second draft guidance after an initial rejection.

NICE recommended Kisplyx for advanced renal cell carcinoma for adults previously treated with one VEGF-targeted therapy – but only if patients are able to walk and carry out non-strenuous work.

A NICE independent committee noted that trial evidence show that on average people live around 10.1 months longer when treated with the combination, than with Afinitor alone.

As is now routine, Eisai offered a confidential discount on the list price of almost £35,000 a year, on top of the cost of Afinitor.

Nevertheless NICE said that there were still uncertainties in the clinical evidence submitted by Eisai, and that cost-effectiveness could still not be effectively estimated.

In an interview with pharmaphorum last month, Hendler, who heads up Eisai’s European operations, argued that NICE is now more interested in securing discounts from pharma than assessing the cost-effectiveness of drugs.

He told pharmaphorum: “We are concerned that they [NICE] doesn’t really value innovation, it is all about driving the price down. They really want more confidential discounts from the manufacturers.”

NICE is increasingly using uncertainty in trial evidence as justification for these price cuts, he argued.

NICE’s review of lenvatinib in thyroid cancer, where it is known as Lenvima, was delayed for two years as its launch coincided with a shake-up of NICE’s processes.