Despite going above and beyond its normal approval processes, UK’s National Institute for Health and Care Excellence (NICE) said “no” to Roche’s breast cancer drug Kadcyla. The organization said it had considered the cost-effectiveness of end-of-life cancer drugs, but concluded in final draft guidance that the price for Roche’s treatment was too high to be available through the NHS.
According to NICE standards, if a treatment costs more than £30 thousand per quality-adjusted life years (QALY), it would not recommend it as cost effective. The QALY of Kadcyla came in at around £166 thousand. The drug is currently being funded at its full list price of more than £90 thousand per patient via the government’s Cancer Drugs Fund.
This rejection didn’t come as a surprise to Sally Greenbrook, senior policy officer of the research organization Breakthrough Breast Cancer. Despite the fact that the drug is “brilliant,” the expensive price tag was a good indication that the drug would not make it past NICE. She said she would ultimately like to see the Department of Health and the pharma industry working more closely to make new treatments more available to patients. “Until then,” she said. “NICE will be forced to reject these cutting-edge treatments, leaving people facing terminal illnesses with fewer treatment options.”
“We are really disappointed that Roche were not able to demonstrate more flexibility to help us provide a positive recommendation,” Sir Andrew Dillon, Chief Executive of NICE, added. “The company is well aware that we could not recommend Kadcyla at the price it proposed.”
Kadcyla is a combination of Herceptin (trastuzamab) with a chemotherapy agent designed to more accurately treat women with HER2-positive breast cancer that has metastasized, cannot be surgically removed, and does not respond to treatment, the Wall Street Journal reported.
NICE reported that the drug could extend overall survival by around six months, as compared to other current treatments, while bringing Roche roughly $2 to $5 billion in annual peak sales.
Nearly 1500 women in England could benefit from Kadcyla. Doctors in England are still able to prescribe it as long as they apply for funding through the centralized Cancer Drugs Fund, though this is only a short-term solution until the drug gets NICE approval.