NICE U-turn on Roche cancer drug
pharmafile | April 4, 2014 | News story | Medical Communications, Sales and Marketing | NICE, Roche, Tarceva, U-turn
Roche’s lung cancer drug Tarceva has been given a reprieve to treat relapsed lung cancer patients in the NHS after cost watchdog NICE lifts its restrictions in new draft guidance.
Following a consultation period NICE reversed its decision to restrict access to Tarceva (erlotinib) for second-line non-small cell lung cancer (NSCLC) patients, a U-turn which Roche says could benefit around 2,000 of those per year.
The drug was approved by NICE for use on the NHS in 2008 for relapsed NSCLC, with around 60% of doctors choosing to prescribe the targeted treatment over chemotherapy, according to the Swiss firm.
But in February NICE issued a new piece of guidance saying it would be limiting access to Roche’s drug, after a review of the existing guidance found that it no longer met the NICE criteria for clinical and cost-effectiveness.
At the time Roche said the new guidance was ‘perverse’ although NICE was adamant that the drug was too expensive for routine use, and that clinical guidance had changed since its initial approval in 2008.
The body’s chief executive Sir Andrew Dillon also pointed out that AstraZeneca’s Iressa (gefitinib), which is in the same class as Tarceva, was also recommended as a cost-effective treatment for NSCLC patients.
Following a consultation with patients, doctors and Roche, however, NICE has now revised its draft guidance to allow Tarceva to be funded on the NHS for relapsed NSCLC.
Roche currently has a patient access scheme which reduces the cost of 30 150mg Tarceva tablets from their list price of £1,631.53 – although the discount has not been made public.
Dr Mick Peake, consultant physician at the University Hospitals of Leicester NHS Trust and Clinical Lead, National Cancer Intelligence Network (NCIN), says: “We are glad that NICE is taking clinical and patient opinion into consideration during the drug appraisal process and is ensuring continued access to the standard of care for second-line lung cancer patients.
“Lung cancer is one of the most difficult cancers to treat and so it is crucial that we have a wide array of treatment options to choose from. I am therefore extremely relieved that erlotinib will continue to be available through the NHS as a treatment option for patients with relapsed NSCLC.”
According to Roche a key factor in NICE’s latest decision was the potentially severe side effects of Tarceva’s rival drug docetaxel, a cheaper chemotherapy treatment for lapsed NSCLC. Any bad side effects can increase the strain on NHS funding, so Roche argues – nd NICE tends to agree – that Tarceva could help save money in this regard.
But Tarceva has its own potentially severe side effects that include gastro-intestinal perforation and interstitial lung disease. It does, however, come in a pill form meaning it can be taken at home, something that can cut hospital visits and thus reduces the overall cost to the NHS when compared to the infusion-based drug docetaxel.
NICE is expected to make a final decision on Tarceva by September.
Ben Adams
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