Back in February, Nice decided provisionally not to recommend it for routine use in England because it had not been found to be a cost-effective use of NHS resources. However, after an improved patient access scheme from the company, and price changes, that decision was reversed.
According to report, breast cancer drug that was rejected for routine NHS use in England earlier this year has now been recommended by health officials after a discount was agreed with the manufacturer.
The decision has been described as “fantastic news for thousands of women” by a charity, which said the introduction of this drug would give “precious extra months” for those who are very unwell.
The draft guidance from the National Institute for Health and Care Excellence (Nice) has recommended the use of abemaciclib – sold by Eli Lilly as Verzenios and given with fulvestrant – which targets breast cancer that has spread to other parts of the body in patients who have not responded to other treatment.
It normally costs £2,950 for a packet of 56 150mg-tablets (excl VAT), but the company has agreed on a discount for the NHS, the terms of which remain confidential.
Delyth Morgan, the chief executive of Breast Cancer Now, said it was “fantastic news for thousands of women with hormone receptor positive, HER2 negative incurable secondary breast cancer”.
She added: “Following its worrying provisional rejection by Nice earlier this year, this decision now secures its future use on the NHS, bringing hope to eligible women who could see this combination treatment offer them precious extra months before their disease progresses and it could even help extend their lives.”
The treatment – a pill taken twice daily – can help manage the side-effects associated with cancer drugs and also delay the need to start chemotherapy and enduring its debilitating side effects, Morgan said.
Abemaciclib is drug called a CDK4/6 inhibitor. It works by inhibiting proteins in cancer cells that allow cancers to grow. “That Nice concluded it met a need for an alternative CDK4/6 inhibitor is testament to the many women who shared their experiences of the treatment with Breast Cancer Now, supporting our work to overturn the initial provisional rejection,” Morgan said.
Abemaciclib is available through the Cancer Drugs Fund (CDF) as an option where exemestane plus everolimus would be the most appropriate alternative treatment to a CDK4/6 inhibitor.
Even with the uncertainty around the clinical and cost-effectiveness estimates, overall, the committee concluded that it, plus fulvestrant, was a cost-effective use of NHS resources.
Other drugs that have been accepted for use after initial rejection, due to discounts offered, include a second line triple therapy for patients in England with multiple myeloma. The therapy has been recommended after a confidential discount was agreed between NHS England and the drug manufacturer Amgen.
Nice also recommended making the drug liraglutide available for those with obesity on the NHS after a confidential discount had been agreed with the manufacturers Novo Nordisk.
Meindert Boysen, the director of the Centre for Health Technology Evaluation at Nice, said: “Advanced breast cancer is an incurable condition, and the aim of treatment is to delay it getting worse and extend survival. The committee heard that CDK4/6 inhibitors like abemaciclib were welcomed by patients because they can delay the time before their cancer gets worse and so delay or avoid the need for chemotherapy.”
“The committee also heard from the patient experts that exemestane plus everolimus, the treatment that would normally be used at this stage, was poorly tolerated and used for only a small number of people because it has similar effects to chemotherapy on quality of life.”
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