A potentially life-extending drug combination for some people with advanced breast cancer will be made available on England’s Cancer Drugs Fund (CDF) following a recommendation by the National Institute for Health and Care Excellence (NICE).
The draft guidance recommended ribociclib (Kisqali, Novartis) with fulvestrant (Faslodex, AstraZenica) as an option for people with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer who have had previous endocrine therapy.
Clinical trial evidence suggested that compared with fulvestrant alone, the cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor with fulvestrant increased the length of time before the disease progressed. However, it was not known whether ribociclib increased the length of time people lived because final trial results were not yet available.
The committee said it recognised that ribociclib with fulvestrant had the potential to be cost-effective, and CDF listing would allow time until the end of 2020 when uncertainties around survival and cost-effectiveness were likely to be resolved.
Ribociclib is given as 3 x 200 mg tablets once daily for 21 consecutive days, followed by 7 days off treatment. A pack of 63 tablets has a list price of £2950. However, the manufacturer agreed to provide the drug at a confidential discount.
Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: “Treatments that can postpone disease progression are important because they can reduce the number of people who are exposed to the often unpleasant side-effects of chemotherapy, and delay the need for its use in others.
“We are pleased therefore that the company has agreed a commercial arrangement for ribociclib that will allow it to be made available to people with this type of breast cancer.”
Subject to appeal, NICE’s final guidance will be published in August.
NICE had already approved abemaciclib (Verzenios, Eli Lilly) (also a CDK4/6 inhibitor) in combination with fulvestrant for the same indication within the CDF.
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