England's Cancer Drugs Fund changes its tune, holds onto Novartis' Afinitor

In the face of a backlash from drugmakers, England's Cancer Drugs Fund (CDF) is backtracking in its decision to remove certain treatments from its list of covered drugs. It has agreed to keep Novartis' ($NVS) cancer med Afinitor for two of the three indications for which it was supposed to be removed.

England's National Health Service will continue to make Afinitor available to women with advanced breast cancer and people with metastatic renal cell carcinoma, but will not cover the drug for individuals with pancreatic neuroendocrine tumors (pNETs) because of the rarity of the condition, a Novartis spokesperson told Pharmafile. Afinitor is available to treat pNETs in Scotland and Wales, and the company said the CDF process "lacks the robustness used by other UK cost-effectiveness bodies." But Novartis agreed to the new Afinitor deal with CDF nonetheless, accepting a delisting of the med for one indication "rather than agreeing to a situation that significantly undervalues our medicine," the company said.

As part of the agreement, Novartis will supply Afinitor to patients with pNETs on a "named patient basis," which requires oncologists to place requests for the meds through their local clinical commissioning group (CCG).

The CDF move could signal a broader about-face. The fund in January announced it would remove certain meds from its covered list to deal with budget overruns and save an estimated £80 million ($121.3 million) a year. The fund is expected to surpass its £200 million ($422 million) annual budget by £100 million by the end of the fiscal year, and government officials pledged an additional £160 million to make up for the difference. In exchange, the government also granted the fund the power to trim its approved list, with the CDF whittling it down to 62 indications from 84.

But the decision triggered backlash from companies such as Novartis, Eli Lilly ($LLY) and Eisai, which were informed ahead of time that some of their treatments would be eliminated from the fund's coverage. Eli Lilly and Eisai appealed the fund's decision, spurring NHS England to rethink its choices on approved indications. Eisai's breast cancer med Halaven may be allowed to remain on the list after the company's appeal was upheld, and Lilly is hoping for a similar victory for Alimta, a non-small cell lung cancer med, after having its appeal partially upheld. The CDF, which met earlier this week to discuss its reconsiderations on covered meds, is expected to issue its final decisions on approved indications soon, Pharmafile reports.

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