NICE recommends Afinitor, Xalkori, as cancer drug review continues

NICE has recommended two cancer drugs, as it continues its review of treatments in the old Cancer Drugs Fund.

In final draft guidance, NICE said an updated cost-effectiveness analysis had convinced it that Novartis' Afinitor (everolimus) daily pill in combination with exemestane (Pfizer's off-patent Aromasin) was effective for breast cancer after endocrine therapy.

The review is part of a wider reappraisal of drugs currently funded on the hugely overspent Cancer Drugs Fund (CDF).  The system is being overhauled, and NICE is reassessing dozens of older drugs with a view to moving them out of the CDF, either into routine use or effectively barred from NHS use.

Novartis is just the latest company to succeed in persuading NICE, with new data but also heavy discounts thought to be the decisive factor behind recommendations.

NICE also considered comments from a patient expert, who said that there are limited options after a woman's disease becomes resistant to endocrine therapy, and because the drug combination may delay the need for chemotherapy and its associated toxicity.

Novartis has also agreed a commercially confidential discount from the list price of £2,673 for a pack of 30 10mg tablets, and £2,250 for a pack of five tablets.

Professor Carole Longson, director of the centre for health technology assessment at NICE, said: “The committee heard that people with breast cancer would value treatments like everolimus that can be given when limited options exist once their disease becomes resistant to endocrine therapy, and because it may delay the need for chemotherapy and its associated side-effects."

Xalkori also recommended

NICE also recommended Pfizer's Xalkori (crizotinib) twice daily oral medicine as a second line treatment for ALK-positive advanced non-small cell lung cancer.

Originally rejected by NICE because of immature data and uncertainty over its overall survival gain, Pfizer provided newer clinical evidence and a further discount from the list price of £4,689 for a 60 capsule pack.

NICE already recommends Xalkori as a first-line option for eligible lung cancer patients.

Earlier this month, NICE rejected Merck KGaA's Erbitux (cetuximab) in head and neck cancer, in draft guidance, following a similar review.