Eli Lilly will be celebrating news that its Alimta has become the first treatment to be cleared by the National Institute for Health and Clinical Excellence for use on the National Health Service as a maintenance therapy for patients with non-small cell lung cancer.

Around 38,000 people in the UK are diagnosed with lung cancer every year, of which 80% have the NSCLC form, and the idea of maintenance therapy - a relatively new concept in care - is to prolong the period of remission after first-line chemotherapy and boost the likelihood of being able to receive a second-line regimen.

The NHS cost regulator has now published final guidance recommending Alimta pemetrexed for maintenance therapy in patients with locally advanced or metastatic NSCLC (apart from those with a predominantly squamous cell histology) whose disease has not worsened following chemotherapy in combination with gemcitabine, paclitaxel or docetaxel.

However, the Institute has stipulated that patients who have received first-line chemotherapy alongside Alimta are then not eligible for treatment with the drug in the maintenance setting, as this scenario appears to have some limitation on efficacy.

The decision is based on clinical data showing that Alimta has the potential to extend life by 22 weeks at an approximate cost of £12,000 per patient per year. According to NICE, the most likely incremental cost for the drug compared with best supportive care is around £47,000 per QALY gained, which it considered acceptable under criteria for appraising end-of-life therapies.

News of NICE’s approval of Alimta will be especially sweet for Lilly given that back in December the drug was actually down because NICE’s Appraisal Committee felt there were “too many uncertainties in the data and analysis” at the time.

Furthermore, just a few weeks ago the cost watchdog published draft guidance rejecting Roche’s rival Tarceva (erlotinib) in the NSCLC maintenance setting, which should give Alimta a relatively free run of the NHS market for some time at least.