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NICE has the habit of rowing with Roche's anticancer drugs, but peace has recently broken out – and now, the recommendation of a new use of Perjeta will make the NHS an early follower.
The breakthrough is due to a reduction of Roche on Perjeta, but especially the arrival of cheaper biosimilars Herceptin (trastuzumab), which have significantly reduced the cost of combination therapy.
The Cost-Effectiveness Center today recommended the new treatment for Roche's Perjeta (pertuzumab) bad cancer in patients with early-stage HER2-positive bad cancer whose disease has spread to lymph nodes, in combination with trastuzumab and chemotherapy.
The recommendation is for people who have had surgery for their bad cancer and whose cancer has already spread to the lymph nodes (positive lymph node disease).
About 2,700 people in this subgroup in England and Wales are at higher risk of seeing their cancer recur, but will be eligible for treatment once the guidelines are finalized in March.
In accordance with the usual procedure, Roche had to offer an improved discount on the price of Perjeta, helping it to cancel the initial rejection of the use by NICE last June.
NICE agrees that clinical trial data show that the addition of Perjeta to standard treatment of older Roche Herceptin drug and chemotherapy after surgery (adjuvant use) has increased the proportion of people whose disease does not occur. was not extended. However, the lack of evidence on overall survival was a sticking point, but this has now been resolved by Roche's (confidential) price offer.
NICE has repeatedly rejected Roche's second-generation bad cancer medicines, Kadcyla and Perjeta, since their launch in the EU in 2013, although significant price cuts have helped them gain ground with NICE in the EU. time.
But the arrival last year of biosimilars Herceptin (trastuzumab) for intravenous administration was an even more important factor in helping the new combinations Perjeta and Herceptin to break even.
The NICE document indicates that this means that the combination is well below its break-even point: "Taking into account the commercial reduction in the price of pertuzumab, as well as the weighted reduction for biosimilar intravenous trastuzumab, the 20,000 profitability estimate by QALY gained. "
NICE already recommends Perjeta, in combination with trastuzumab and chemotherapy, to treat HER2-positive bad cancer before surgery and for metastatic or locally unresectable HER2-positive bad cancer.
According to Roche, NICE's decision to offer Perjeta to patients whose HER2-positive bad cancer has spread to their lymph nodes places the NHS at the forefront of adopting this new use.
Richard Erwin, Managing Director of Roche UK (pictured) said: "Roche has worked closely with NICE and other stakeholders in the healthcare sector to help make Perjeta available as quickly as possible. We are therefore delighted that England and Wales is one of the first countries in the world where these patients can obtain routine access to Perjeta as part of adjuvant therapy. "
Herceptin sales reached $ 6.94 billion last year, but fell 16% in Europe due to biosimilar competition. Perjeta's sales reached $ 2.77 billion, with Europe contributing 15% growth. Roche continues to support the growth of Perjeta and Kadclya by multiplying trials exploring their use in older environments.
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