NICE rejects Pfizer’s first-in-class breast cancer drug

pharmafile | February 3, 2017 | News story | Medical Communications, Sales and Marketing NICE, Pfizer, breast cancer 

NICE has published draft guidelines which reject Pfizer’s Ibrance (palbociclib) based primarily on the cost of the drug but also with reservations about improvement of overall survival in patients. The drug to treat breast cancer has been shown, in clinical trials, to delay the growth of cancer by an extra 10 months compared with standard treatment.

The decision has led to strong criticism from the various organisations, as standard treatment is able to delay growth of cancer by 14.5 months while clinical trials display a hold on growth of 24.8 months. This extension could prove significant to the 5,500 people with hormone-positive, HER2 negative breast cancer within the UK.

The point of contention is that Ibrance costs £79,650 for a full course of treatment, an expense that NICE deems too excessive to be able to fund. Inevitably, this will lead to wrangling between the body and Pfizer to find a compromise on price.

The Institute of Cancer Research has been particularly forthcoming in their disappointment upon the decision. Dr Nicholas Turner, Team Leader in Molecular Oncology at The ICR said of the guidance: “Palbociclib is one of the most important advances in treating the most common type of breast cancer in 20 years. Clinical trials show the drug can substantially slow the progression of the disease and help delay chemotherapy, which often has life-limiting side-effects. It is very disappointing that palbociclib is not being made available to patients, but cost is the limiting factor. If the manufacturer, NICE and NHS England can find a way of making this treatment available for patients, they will substantially improve the lives of patients with breast cancer.”

The main factor appears, as Turner identifies, to be the cost. However, NICE also stressed that there needed to be more evidence of the impact beyond delay in the growth of the cancer. “The committee needs more evidence of the drug’s impact on overall survival of people with breast cancer. However, even when allowing for these potential benefits, it was still not enough to make palbociclib cost effective at its current price,” said Professor Carole Longson, director of the NICE Centre for Health Technology Assessment. 

There are currently patients taking Ibrance, and NICE has recommended that those patients should continue with the treatment until their doctors recommends them to cease the treatment. The draft guidelines will now be open to public comment.

Ben Hargreaves

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