NICE says yes to four cancer drugs, rejects Lilly’s Cyramza

Cancer

Four new oncology drugs and a treatment for the lung disease idiopathic pulmonary fibrosis (IPF) have been recommended by NICE – but Lilly's cancer medicine Cyramza has been turned down.

The UK's cost- and clinical-effectiveness body has given final recommendation to four cancer drugs: AstraZeneca's Lynparza (olaparib) for ovarian, fallopian tube and peritoneal cancer; Bayer's Xofigo (radium 223 dichloride) and Astellas' Xtandi (enzalutamide), both for prostate cancer, and Novartis' Farydak (panobinostat) for multiple myeloma.

The drugs had all previously been rejected by NICE and this final approval comes after the companies either re-submitted data or dropped their prices – or both.

In addition to these approvals, NICE has also given the green light to Boehringer Ingelheim's Ofev (nintedanib) for idiopathic pulmonary fibrosis (IPF), a scarring to the lungs which worsens and can be fatal.

Among the good news, Lilly's Cyramza (ramucirumab) stands out for failing to gain approval. NICE ruled that the treatment for advanced gastric cancer or gastro-oesophageal junction adenocarcinoma had not demonstrated enough benefit to patients to justify its high cost. NICE estimated its cost to be £36,000 as part of combination therapy (with paclitaxel) and £21,000 as monotherapy for an average treatment duration.

The company's trials showed combination therapy improved overall survival by just 2.27 months, and only 1.4 months as a monotherapy. Compelling evidence of improved quality of life was not provided either.

The news is particularly bad for Lilly's drug as, where once the drug would have been funded via England's Cancer Drugs Fund (CDF) if rejected by NICE, this route is not currently available.

The CDF is set to be re-launched from April this year as a 'managed access' fund overseen by NICE. However, the new Fund is likely to appraise only brand new drugs, not ones such as Cyramza, which are already on the market and have already been reviewed.

Read all the recommendations here.

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Scrap the Cancer Drugs Fund, we need a value-based system for all innovative products 20 November 2015

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Andrew McConaghie