NICE U-turn on Pfizer drug Inlyta
NICE has recommended that Pfizer’s kidney cancer drug Inlyta should be used for some patients in England, following a similar decision last year by the Scottish Medicines Consortium.
Oral selective tyrosine kinase inhibitor Inlyta (axitinib) can now be used on the NHS for treating advanced renal cell carcinoma, after failure of prior treatment with a first-line kinase inhibitor or a cytokine, according to the draft guidance.
However, as in Scotland, this option will only be taken up if the manufacturer provides the drug at an undisclosed discount agreed in its patient access scheme.
Pfizer’s own kinase inhibitor Sutent (sunitinib) and GlaxoSmithKline’s Votrient (pazopanib) are already recommended by NICE as first-line treatments for the disease, which starts in cells lining the small tubes that help to make urine.
In advanced cases, the tumour will have spread inside the kidney and might have gone into lymph glands nearby as well.
In earlier guidance NICE had said Inlyta was not cost-effective, but has changed its mind after Pfizer came up with more data to support its case.
“NICE issued an updated scope and matrix to include sunitinib and pazopanib as comparators in addition to best supportive care for the post-cytokine sub-group, and the manufacturer of axitinib submitted more information on how well it works in this group of patients,” explained Carole Longson, NICE’s Health Technology Evaluation Centre director.
“After careful consideration of this evidence, including the proposed patient access scheme, the independent Appraisal Committee concluded that axitinib should be recommended as a treatment option for adults with advanced kidney cancer in specific circumstances,” she added.
NICE thinks Inlyta’s ‘most plausible’ cost per QALY after Sutent would be between £33,500 and £52,900, and after cytokine treatment it would be £33,000.
The draft guidance is now out for consultation.
The key evidence for Inlyta in RCC comes from the Phase III AXIS study which compared Inlyta to Bayer and Onyx’s Nexavar (sorafenib) in the second-line treatment of RCC.
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