Although recently rejected by the National Institute for Health and Care Excellence, the Welsh government has given the thumbs-up to Celgene’s Abraxane to be available on the National Health Service there for pancreatic cancer.

Abraxane (nab-paclitaxel) has been recommended by the All Wales Medicines Strategy Group as an option for use within NHS Wales in combination with gemcitabine for the first-line treatment of adult patients with metastatic adenocarcinoma of the pancreas. Following the appraisal by AWMSG, Health and Social Services Minister Mark Drakeford said “we will be making the medicine available on the Welsh NHS to those who are eligible to receive it”.

He added: “I am proud that in Wales we have a system in place where patients get access to proven and effective treatments for cancer and other life-threatening conditions”.

Earlier this month, NICE rejected Abraxane for advanced pancreatic cancer, saying that data provided by Celgene show that the chemo regimen FOLFIRINOX, a first-line option for patients with the disease, was actually more clinically effective than the Abraxane/gemcitabine combo.

NICE also argued that the most plausible cost per QALY (Quality Adjusted Life Year) gained for Abraxane/gemcitabine compared with gemcitabine alone was £78,500 per QALY gained, well above the normal bounds of what is considered a cost-effective use of NHS resources (up to £50,000 in certain life-extending circumstances).

Decision could be reversed, depending on NICE

Responding to the Wales decision, Celgene UK told PharmaTimes that this is “a real step forward in a disease area with limited treatment options and such a poor prognosis”. However, it noted that if NICE’s recent negative preliminary recommendation is upheld, it would mean that the AWMSG decision “would be reversed and patients in Wales would no longer be able to access this clinically effective treatment”.

The company told PharmaTimes that a discount was not deemed necessary by the AWMSG and approximately 100 patients per year will be eligible to receive Abraxane in Wales.

The news also went down well with Pancreatic Cancer UK and chief executive Alex Ford said it gives clinicians “another weapon in their armoury”. She added that while patients will still need to meet “certain medical eligibility criteria, such as being fit enough to tolerate the treatment regime, it means more…will get access to life-extending drugs”.

Ms Ford concluded by saying “we now want to see Scotland, Northern Ireland and England follow suit so that many more patients and their loved ones will also be able to benefit from this treatment”.