The National Institute for Heath and Care Excellence is supporting the use of Sanofi's prostate cancer drug Jevtana on the National Health Service following a second cost-appraisal of the drug.

The Institute has now published guidelines endorsing Jevtana (cabazitaxel) in combination with prednisone or prednisolone to treat metastatic hormone relapsed prostate cancer in people whose disease has progressed during or after docetaxel chemotherapy.

However, the therapy should only be used if the person has an eastern cooperative oncology group (ECOG) performance of 0 or 1, and has had 225 mg/m2 or more of docetaxel.

In other stipulations, NICE says treatment should be stopped when the disease progresses or after a maximum of 10 cycles (whichever happens first), and that NHS trusts purchase the drug in preprepared intravenous infusion bags, not in vials. 

The appraisal committee had initially rejected Jevtana because of concerns about its cost-effectiveness compared with standard treatments (such as abiraterone, enzalutamide or radium-223 dichloride). But Sanofi then increased the discount and confirmed that it can supply the drug in intravenous bags instead of vials, reducing waste and increasing its cost-effectiveness.

Between 2013 and 2015, over 550 patients accessed Jevtana (as a second-line treatment after docetaxel) through the Cancer Drugs Fund. Now, with this positive recommendation from NICE, the drug will move out of the CDF and into routine use, although the number of patients accessing it is not anticipated to change as a result.

"In these times of austerity, it is even more important to ensure that we're getting good value for the NHS," said Professor Carole Longson, director of the Centre for Health Technology Evaluation at NICE. "I am very pleased that this improved discount for cabazitaxel means we are now able to recommend it. This is an excellent example of how pharma companies can work with us to ensure that patients have access to all of their treatment options."