NICE has been swayed to recommend two new melanoma treatments after their respective manufactures promised to lower the price of their drugs.
Roche’s Zelboraf (vemurafenib) pill and Bristol-Myers Squibb’s cancer vaccine Yervoy (ipilimumab) have now been recommended in final guidance to treat advanced melanoma, the deadliest form of skin cancer.
The UK pricing watchdog had originally been minded not to recommend the treatments, but a confidential price discount by both firms has seen NICE have a change of heart.
Zelboraf is now recommended for the treatment of unresectable locally advanced or metastatic BRAF V600 mutation-positive melanoma, which is present in around half of all melanoma patients and could treat as many as 1,000 people in England and Wales.
Yervoy is recommended for the treatment of advanced malignant melanoma in people who have received prior chemotherapy, and can possibly treat a maximum of 500 patients. These are the first two personalised medicines for the treatment of melanoma, with the NHS traditionally relying on the chemotherapy treatment dacarbazine, or simply palliative care.
The drugs are two of the most expensive NICE has ever appraised, with Zelboraf costing £52,000 per patient per year, and Yervoy costing £75,000 on average, without including administration costs.
But NICE said it could allow these treatments through because of the confidential price discount to Yervoy and Zelboraf, and because they both met NICE’s end-of-life criteria, which allows the watchdog more room for manoeuvre on expensive drugs that have been proven to extend life.
Both firms also provided NICE with additional data and analysis regarding the cost effectiveness of their drugs, which again made NICE’s positive recommendation easier.
Professor Carole Longson, health technology evaluation centre director at NICE, said: “Advanced melanoma can significantly affect patients’ quality of life and without effective new therapies, the prognosis for advanced disease is very poor. For many years the treatments available for this condition have been very limited and in some cases restricted to palliative care.
“Vemurafenib and ipilimumab are breakthrough treatments that can potentially significantly improve the prognosis for some people with malignant melanoma. We are very pleased that the manufacturers have worked with us so that we are now able to recommend both treatments.”
Cancer Drugs Fund
Both drugs have, however, been accessed by English patients via the UK Government’s Cancer Drug Fund over the past year, as a £200 million ring-fenced fund to pay for oncology medicines that have been rejected by NICE, or are currently under appraisal.
According to Department of Health data obtained by PharmaTimes UK News, Zelboraf was accessed 124 times through the Fund, in the first six months of 2012, with Yervoy proving more popular after being approved 248 times.