Pfizer’s cancer drug too expensive for NICE

Pharma NICE Update NICE has failed to recommend Pfizer’s Xalkori (crizotinib) for previously treated anaplastic-lymphoma-kinase-positive advanced non-small-cell lung cancer in new draft guidance.

An independent Appraisal Committee decided the drug did not meet NICE’s end-of-life treatment criteria so its cost exceeded the limit deemed cost-effective for NHS use.

Sir Andrew Dillon, NICE Chief Executive, said that although the clinical benefits of Xalkori had been recognised the high cost of the drug meant it could not be considered as a treatment option.

NICE usually recommends clinically effective treatments that cost up to at a maximum of up to £30,000 per quality adjusted life year (QALY) – the methodology current used to assess value.

If certain treatments meet the criteria to be considered under NICE’s supplementary advice for end-of-life treatments a higher cost per QALY may be accepted. The highest cost per QALY NICE has recommended has been around £50,000.

However, NICE’s Appraisal Committee concluded that the most plausible cost per QALY for Xalkori would be somewhere between £63,800 and £181,100 when compared with existing treatments and between £51,700 and £80,500 when compared with best supportive care.

“We have already recommended a number of treatments for the various stages of non-small-cell lung cancer,” said Sir Andrew Dillon. “However, although the independent committee that considered the evidence found crizotinib to be clinically effective treatment for ALK-positive non-small-cell lung cancer, even if the supplementary advice to the Committee for life-extending treatments had applied, crizotinib could not be considered a cost-effective use of NHS.”

NICE’s guidance is now open for consultation.