Boehringer’s first cancer drug gains NICE yes

pharmafile | March 17, 2014 | News story | Sales and Marketing Boehringer, Cancer, NICE, NSCLC, afatinib, giotrif 

NICE is recommending that Boehringer Ingelheim’s first oncology treatment Giotrif be funded by the NHS.

The new final draft guidance recommends Giotrif (afatinib) as an option for treating locally advanced or metastatic non-small-cell lung cancer (NSCLC) in people whose tumours test positive for the EGFR-TK mutation, and have not received treatment with any other EGFR-TK inhibitor.

The drug has been fast-tracked into the final stage of the NICE process, and could be available to NHS patients this quarter.

This medicine was the first oncology treatment to reach the market from Boehringer after being approved by the FDA last year.

It may have been expecting a tougher ride through the NICE process, given that the body failed to give any final positive recommendations to any cancer drugs last year, but has managed to negotiate the pitfalls to gain today’s backing.

Price cuts

One of the reasons for its success will no doubt come down to the cost – the NHS list price will be £2,023.28 per pack of 28 tablets (20 mg, 30 mg, 40 mg or 50 mg). This means that the anticipated NHS list price per course of treatment is expected to be around £22,000 per patient, based on a progression-free survival of 11 months.

But NICE said that Boehringer has offered a patient access scheme for the medicine that discounted its overall price tag, although the size of the cut has not been made public.

The drug is a targeted therapy known as an EGFR-TK inhibitor and works by blocking the signal pathways helping to slow the growth and spread of tumours.

NSCLC is now tested for EGFR-TK mutation status at diagnosis before people receive their first-line therapy, to ensure that the most appropriate treatment is selected.

This means that Giotrif could be used as the first port of call for these patients, and used ahead of older treatments Tarceva (erlotinib), made by Roche, and AstraZeneca’s Iressa (gefitinib).

Commenting on the draft guidance Sir Andrew Dillon, chief executive of NICE, says: “We’ve already recommended two drugs, gefitinib and erlotinib, as options for the first-line treatment for patients with this form of lung cancer and we’re pleased that this draft guidance recommends a further option.

“As the independent committee is recommending the treatment in line with its marketing authorisation, they decided that an appraisal consultation document was not needed for this appraisal.

“In accordance with our usual process, the recommendations can therefore go straight to a final draft in order to speed up access to this treatment. The draft guidance is now with consultees, who have the opportunity to appeal against it.”

This decision comes after NICE rejected Pfizer’s targeted lung cancer treatment Xalkori (crizotinib) in September last year, stating its cost was too high for the NHS.

Ben Adams

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