NICE says Celgene’s Abraxane is ‘too expensive for pancreatic cancer’
pharmafile | September 17, 2015 | News story | Sales and Marketing | Abraxane, Celgene, NICE, Pancreatic cancer
NICE has decided not to recommend Abraxane (nab-paclitaxel) by Celgene in combination with gemcitabine for adults with metastatic pancreatic cancer.
In its final appraisal determination (FAD) the industry watchdog claimed the cost of using the medication was not justifiable, and that it had limited benefits compared to currently-available treatments.
In final draft guidance, NICE states that Abraxane, when given with the chemotherapy drug gemcitabine, should not be funded by the NHS for people whose pancreatic cancer has spread and who have not received any other treatments.
Sir Andrew Dillon, NICE chief executive, says: “Pancreatic cancer has no obvious warning signs, so many people are not diagnosed until their cancer is advanced. Prognosis is poor and without treatment people may live for only two to six months.
“Unfortunately, the development of new treatments for pancreatic cancer has been very limited in recent years. Although nab-paclitaxel is more effective than one of the treatment options currently available, it is linked with more side effects. When considering the impact of side effects on a patient’s quality of life and the fact that it is also more expensive, nab-paclitaxel cannot be considered an effective use of NHS resources.”
This decision has been made despite the Scottish Medicines Consortium (SMC) and the All Wales Medicines Strategy Group (AWMSG) accepting Abraxane in combination with gemcitabine for use in their countries, for the treatment of metastatic pancreatic cancer.
Pancreatic cancer has a poor prognosis, with survival rates being amongst the worst of common cancers in England and Wales; approximately 80 per cent of adult patients in England and Wales do not survive one-year post diagnosis.
Today’s negative decision by NICE not only has implications for patients being able to access Abraxane in combination with gemcitabine via the NHS in England, but also in Wales.
Wim Souverjins, General Manager at Celgene UK & Ireland, had previously stated that the removal of Celgene medications from the Cancer Drugs Fund would make it harder for the company to justify investment into clinical trials in the UK.
On NICE’s latest decision, he comments: “Celgene is extremely disappointed by the NICE decision on Abraxane, which comes after a turbulent nine months of review, but we remain committed to searching for solutions for patients who are demanding this medicine.
“The process to secure reimbursement and ensure patient access to medicines, such as Abraxane in combination with gemcitabine in England, is not fit for purpose. Cancers with devastatingly high levels of unmet need require a different threshold of consideration and until we have that, we will be denying terminal cancer patients access.
“Further, this decision is effectively sidelining English scientists in the fight against pancreatic cancer, as they will not have the option of Abraxane for future research efforts. It is our hope that such research could yield similar results as has been seen in breast cancer.”
The Appraisal Committee was also asked to look at whether the current Pharmaceutical Price Regulation Scheme (PPRS) would affect the drug’s cost-effectiveness, concluding that the rebate provided by the company to the Department of Health could not be taken into account as there was no guarantee it would be directly re-invested in the NHS and could not be considered a nationally-available price reduction that was relevant for use in cost-effectiveness analyses.
Yasmita Kumar
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