Patients with advanced skin cancer in England and Wales will welcome news that cost regulators have changed their position on the first-line use of Bristol-Myers Squibb's Yervoy (ipilimumab).

In draft guidance, the National Institute for Health and Care Excellence (NICE) has now endorsed the drug's first-line use on the National Health Service to treat advanced malignant melanoma which is either unresectable or metastatic, after the drugmaker submitted further analysis showing its potential benefit to patients.

Back in February the Institute had turned down Yervoy's use in this setting, noting that evidence to show the degree to which the drug can extend life compared with standard care was missing - this has now been addressed by B-MS.

Yervoy costs £3,750 per 10-ml vial or £15,000 per 40-ml vial, but B-MS has also agreed a patient access scheme with the Department of Health, in which the drug will be sold to the NHS at a discounted price. 

The Committee concluded that the most cost per Quality Adjusted Life Year (QALY) was £47,900 for ipilimumab compared with the chemotherapy dacarbazine and £28,600 per QALY compared with Roche's Zelboraf (vemurafe