Johnson & Johnson unit Janssen said it is delighted that National Health Service cost regulators for England and Wales have recommended the use of Zytiga in prostate cancer.

Specifically, the National Institute for Health and Clinical Excellence has published final guidance endorsing the drug as an NHS treatment option for patients in England and Wales with metastatic castration resistant prostate cancer (mCRPC), if their disease has progressed despite having received a docetaxel-containing chemotherapy regimen.

According to the drugmaker, Zytiga (abiraterone acetate) - which, it notes, was discovered in the UK - has been shown to prolong life in some patients with advanced prostate cancer.

The decision is certainly good news for patients as there have been few treatment options available for this stage of disease, and according to NICE's appraisal committee, Zytiga offers a step change in treatment "because it is an oral drug taken by patients at home".

News of its NICE acceptance will be particularly sweet for the company, as it reverses an earlier decision to reject the drug on grounds that it failed to hit cost-effectiveness targets.

However, additional data and a revised Patient Access Scheme (PAS) submitted by Janssen - under which the firm offers Zytiga to the NHS at a discounted price - helped secure a subsequent recommendation.

The list price of Zytiga is £2,930 for a 30-day supply of 120 tablets, and its cost per QALY (quality adjusted life year) was judged to fall under £50,000 including the NHS discount.

Tarceva welcomed...

Elsewhere, the Institute also published a final technology appraisal endorsing the use of Roche's Tarceva (erlotinib) as a treatment for locally advanced or metastatic EGFR mutation-positive2 non-small-cell lung cancer.

According to Roche, around 11% or so of patients with NSCLC have the specific mutation, and Tarceva "nearly doubles the time these patients lived without their disease progressing compared with standard chemotherapy (9.7 months compared with 5.2 months)".

The cost of a pack of 30 (150-mg) tablets is £1,631.53, but Roche has also agreed a revised PAS with the Department of Health in which a confidential discount from the list price is applied to original invoices to help boost its value to the NHS.

...Botox too

Also new on the NHS treatment list is Allergan's Botox (botulinum toxin type A), which has been accepted for use as an option for patients with chronic migraine.

Chronic migraine - defined as headaches on at least 15 days per month of which at least eight days are with migraine - is a debilitating condition estimated to affect around 1.6% of adults.

Botox was approved as the first preventative treatment for migraine back in 2010, after the company submitted clinical trial data showing that nearly 70% of patients treated with the drug experienced a 50% reduction in migraine days, as well as a significant improvement in quality of life and headache-related disability scores compared with those given a placebo.

NICE's committee concluded that the most likely cost effectiveness estimate for Botox was £18,900 per QALY, which falls well within the threshold of what is considered to be value for the NHS.