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Cancer drugs funding

Two 'not cost effective' drugs face being dropped from cancer drugs fund

Two drugs may be dropped from the cancer drugs fund (CDF) after the National Institute for Health and Care Excellence (NICE) deemed them “not cost effective”. 

In draft guidance published on 18 August 2016, appraisals carried out by NICE under the new CDF system conclude that everolimus (Afinitor; Novartis) for breast cancer and ibrutinib (Imbruvica; Janssen) for mantle cell lymphoma are not cost effective, which means they may made unavailable for patients with these indications on the NHS in England. 

The appraisal of everolimus looked at the drug in combination with exemestane for treating HER2-negative, hormone-receptor-positive advanced breast cancer in postmenopausal women with refractory/recurrent disease. 

Novartis put forward a new patient access scheme offer and submitted updated survival data. While the appraisal committee says the drug does slow breast cancer growth, it says its effect on survival is less substantial than when NICE issued negative guidance on everolimus in 2013. 

“The committee considered that even with the price discount in the revised patient access scheme, everolimus plus exemestane would not be cost effective,” says Sir Andrew Dillon, chief executive of NICE. 

An appraisal of ibrutinib for relapsed/refractory mantle cell lymphoma also found that even with a new patient access scheme offered by manufacturer Janssen, the drug came in above NICE’s cost-effectiveness threshold in all but one scenario considered. 

NICE is currently reappraising the 41 drugs that were previously covered by the CDF, the revamped version of which was launched at the end of July 2016. It can now either recommend cancer drugs for routine commissioning on the NHS; recommend them for CDF use; or not recommend them at all. 

The draft guidance on everolimus and ibrutinib is out for consultation until 9 September 2016.

  • This story was amended on 19 August 2016 after NICE issued a clarification to say it is advising that everolimus and ibrutinib are not cost effective, but this will not necessarily mean they are removed from the CDF.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20201601

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