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NICE recommends Pfizer's Vizimpro, rejects AstraZeneca's Tagrisso, in non-small cell lung cancer

Published on 05/07/19 at 09:39am

NICE has announced its decision to recommend Pfizer’s Vizimpro (Dacomitinib) in the treatment of non-small-cell lung cancer (NSCLC) – a U-turn on its previous decision to reject the drug for being an ineffective use of NHS resources.

The recommendation, made after the manufacturer agreed to a confidential discount, will make the drug available on the health service specifically in locally advanced or metastatic NSCLC, that has tested positive for the epidermal growth factor receptor (EGFR) mutation. It is thought that around 1,477 patients will be eligible to receive the drug per year.

The ruling was backed up by data which showed that patients using the therapy achieved longer overall survival times, measured as 34.1 months compared to 26.8 months for those using AstraZeneca’s NICE-approved Iressa (gefitinib). Additionally, Vizimpro led to longer progression-free survival times of 14.7 months compared to 9.2 months with Iressa, although it was noted that the drug showed a higher incidence of side-effects.

“Our committee acknowledged that dacomitinib had the potential to extend life for people with this type of lung cancer more than existing treatments currently available on the NHS,” commented Meindert Boysen, Director of the Centre for Health Technology Evaluation at NICE. “Responsible pricing by the company has allowed our committee to reconsider their initial decision. This has led to the positive recommendation announced today, allowing patients to benefit from this innovative treatment on the NHS.”

The news of the ruling was accompanied by the announcement that NICE had decided not to give a positive decision to AstraZeneca’s Tagrisso (osimertinib) in the same indication, deeming it an inefficient use of NHS resources.

AstraZeneca made it known that it plans to appeal the decision. CEO Pascal Soriot remarked on the decision: “We are very disappointed with this decision and will appeal. The UK has the second worst lung cancer survival outcomes in Europe and patients need new innovative treatments. NHS data show that the patients in England who would be eligible for first-line treatment with our medicine have very low survival rates and therefore Tagrisso should qualify for End of Life consideration to evaluate cost-effectiveness. Despite this, NICE has decided these data and the unprecedented benefits of our medicine are not enough to grant EoL criteria. As a consequence lung cancer patients in England will be deprived of a much needed new treatment option that is already available to patients in many other European countries and around the world.

“It is time for a comprehensive review of how NICE values innovative medicines," he continued. "This is needed to ensure British patients can access the latest medical advances, to support the ambitions of the NHS Long Term Plan to improve outcomes for people with cancer, and to help deliver Government’s ambition that the UK continues to be a globally leading centre for life sciences. Sadly in this instance, Tagrisso, a British discovery, will not be available to patients in England when many countries around the world have already decided to reimburse this medicine.”

Matt Fellows

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