Breast cancer drug approved for NHS after manufacturer accepts rebate | Breast cancer



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A breast cancer drug that was rejected for routine use by the NHS in England earlier this year has now been recommended by health authorities after a discount was agreed with the manufacturer.

The move was called “fantastic news for thousands of women” by a charity, which said the introduction of the drug would give “precious extra months” to those who are seriously ill.

The National Institute for Health and Excellence in Care (Nice) draft guidelines recommended the use of abemaciclib – sold by Eli Lilly as Verzenios and administered with fulvestrant – which targets cancer of the breast. breast that has spread to other parts of the body in patients who have not responded to other treatment.

In February, Nice tentatively decided not to recommend it for routine use in England as it had not been deemed to be a cost-effective use of NHS resources. However, after an improved patient access program from the company and price changes, that decision was overturned.

It normally costs £ 2,950 for a pack of 56 150 mg tablets (excluding VAT), but the company has agreed to a discount for the NHS, the terms of which remain confidential.

Delyth Morgan, CEO of Breast Cancer Now, said it was “fantastic news for thousands of women with incurable hormone receptor positive and HER2 negative secondary breast cancer.”

She added: ‘Following its disturbing interim rejection by Nice earlier this year, this move now secures its future use on the NHS, bringing hope to eligible women who could see this combined treatment give them precious additional months. before their disease progresses and it might even help extend their life.

The treatment – one pill taken twice a day – can help manage side effects associated with cancer drugs and also delay the need to start chemotherapy and endure its debilitating side effects, Morgan said.

Abemaciclib is a medicine called a CDK4 / 6 inhibitor. It works by inhibiting proteins in cancer cells that allow cancers to grow.

“The fact that Nice concluded that it met the need for an alternative CDK4 / 6 inhibitor is testament to the many women who shared their experiences of treatment with Breast Cancer Now, supporting our work to reverse the initial provisional rejection,” said Morgan said.

Abemaciclib is available through the Cancer Drugs Fund (CDF) as an option where exemestane plus everolimus would be the most appropriate alternative treatment to a CDK4 / 6 inhibitor.

Even with the uncertainty surrounding clinical and cost-benefit estimates, overall the committee concluded that, in addition to fulvestrant, this was a cost-effective use of NHS resources.

Other drugs that were accepted for use after the initial rejection, because of the discounts offered, include second-line triple therapy for multiple myeloma patients in England. The therapy was recommended after a confidential handover was agreed between NHS England and drugmaker Amgen.

Nice also recommended making the drug liraglutide available to obese people on the NHS after a confidential discount was agreed with manufacturers Novo Nordisk.

Meindert Boysen, Director of the Center for Health Technology Assessment in Nice, said:Advanced breast cancer is an incurable disease and the goal of treatment is to delay its deterioration and prolong survival. The committee heard that CDK4 / 6 inhibitors like abemaciclib were welcomed by patients because they can delay the worsening of their cancer and thus delay or avoid the need for chemotherapy.

“The committee also heard expert patients say that exemestane plus everolimus, the treatment that would normally be used at this stage, was poorly tolerated and was only used for a small number of people because it has similar effects. to chemotherapy on quality of life. “

Nice plans to publish its final recommendations on abemaciclib given with fulvestrant for metastatic hormone receptor positive and HER2-negative breast cancer in September.

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