NICE says no to Kadcyla, cites higher price than Cancer Drugs Fund

Roche’s breast cancer drug Kadcyla has been rejected by NICE, which says its price is still too high.

The decision is the latest round in a long-running battle between Roche and NICE over Kadcyla, one of the most expensive cancer drugs in the UK.

England’s cost-effectiveness watchdog first issued a draft negative decision on the drug in August 2014, but Roche won an appeal against it regarding the PPRS pricing scheme. This has held up the decision, and NICE was eventually able to dismiss Roche’s claim, which would have made it easier for Kadcyla to gain NICE recommendation.

Then, just two weeks ago, Roche agreed to cut the price of Kadcyla to allow it to stay on England’s controversial Cancer Drugs Fund (CDF) – but NICE hasn’t been offered the same discount.

Although the size of the price reduction hasn’t been made public, NICE knows what price has been offered to the CDF, and says its discount is smaller.

Sir Andrew Dillon, NICE Chief Executive, said: “We recognise that Kadcyla has a place in treating some patients with advanced breast cancer and we have been as flexible as we can in making our recommendation. However, the price that the manufacturer is asking the NHS to pay in the long-term is too high.”

Kadcyla is licensed to treat HER2-positive breast cancer which has spread to other parts of the body, cannot be surgically removed and has stopped responding to initial treatment. NICE says it costs about £90,000 per patient at its full list price, but Roche says this estimation is far too high. While not offering exact figures, Roche has indicated to pharmaphorum that the cost offered to the CDF before this month was around £50,000.

NICE says it has not received any further offers from Roche to reduce the price of Kadcyla.

Sir Andrew added: “Despite a growing public campaign for a fair deal on the cost of important new cancer medicines, it is disappointing that there appears to have been no meaningful attempt by Roche to reconsider its price to secure Kadcyla’s long-term future in the NHS, outside of the Cancer Drugs Fund.”

This draft guidance is now subject to an appeal process whereby consultees can appeal against the recommendation, subject to certain criteria.

The decision comes just a day after Roche’s chief executive Severin Schwan and NICE’s chairman Dr David Haslam addressed the FT Pharmaceutical and Biotech conference in London, both commenting on how to address the problem of funding and access to drugs.

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