Xalkori gains NICE approval after price cut

Pfizer’s targeted lung cancer drug Xalkori (crizotinib) has been recommended by NICE after the company offered a price cut.

The decision means NICE has been able to reverse its earlier decision to not fund the drug.  The good news for Pfizer comes at a time of renewed controversy about cancer drug funding in England.

A new version of the Cancer Drugs Fund (CDF) has just been launched, and NICE is currently reviewing ‘legacy drugs’ from the old CDF. NICE has today also issued rejections of Novartis’ breast cancer drug Afinitor and Janssen’s Imbruvica for mantle cell lymphoma.

In light of serious doubts about the new CDF, Pfizer has done well to secure approval through NICE's 'mainstream' appraisal system - even if it has had to cut its price.

Xalkori is the first pill for advanced non-small-cell lung cancer (NSCLC) and is for patients with the rare ALK+ mutation.  These represent about 2% of all NSCLC patients.

NICE says that because the oral drug allows patients to avoid taking intravenous chemotherapy given every three weeks, it not only offers a simpler regimen for them, but also frees up hospital staff and resources.

At its full price, Xalkori costs around £51,000 per patient for a course of treatment.  The price reduction that Pfizer has offered remains confidential, although cuts to cancer drugs in these negotiations are usually in the region of 25-50%.

Around 459 patients are expected to be eligible for first-line treatment with Xalkori in England and Wales.

The draft guidance is now with consultees, who have the opportunity to appeal against it.

The drug will also benefit from new Cancer Drugs Fund arrangements - all cancer drugs that receive a draft positive NICE recommendation are immediately eligible for interim funding by NHS England.  This means the usual three month pause to allow the NHS to prepare for new drugs doesn’t apply to new oncology treatments.