England's price watchdog writes off Celgene's Imnovid in final guidance

NICE CEO Sir Andrew Dillon

England's cost-effectiveness gatekeeper is singing an increasingly harsh tune when it comes to greenlighting cancer drugs, and Celgene's ($CELG) Imnovid is the latest med to get a thumbs-down from the watchdog.

The National Institute for Health and Care Excellence (NICE) gave a "no-go" to the New Jersey drugmaker's third-line multiple myeloma treatment in final draft guidance. NICE CEO Andrew Dillon said in a statement that the company's own analyses show that the drug's benefit does not justify its high price tag when there are already several treatment options available to patients, which include Celgene's own Thalomid (thalidomide) and blockbuster Revlimid (lenalidomide) as well as Johnson & Johnson's ($JNJ) Velcade (bortezomib) to treat myeloma.

Celgene is "clearly disappointed by NICE's decision … as we provided the health technology body with the best evidence available for an oral treatment for relapsed and refractory multiple myeloma that can be taken at home and has been shown both to extend life and also improve the quality of life," said Adrian Kilcoyne, medical director at Celgene UK & Ireland (as quoted by PharmaTimes). He added that the company is in discussions with NICE and the Department of Health to find "an appropriate solution" that allows patients to access Imnovid in the long term.

NICE's latest move also comes amid a wave of cancer drug rejections. A recent analysis found that cancer drugs were 56% more likely to be rejected by the cost gatekeeper than noncancer meds, which were only turned down 16% of the time. Even though NICE's decisions have sparked public outcry, Dillon is quick to pin the problem on drugmakers. The NHS "isn't a bottomless pit," he told the Financial Times last summer. "[W]e shouldn't mislead ourselves into thinking that there is some world we will reach … where everything that could conceivably make a difference to us, whatever its price, is going to be available."

This is not the first time Celgene has found itself in this position with NICE; the cost gatekeeper turned down the company's sales superstar Revlimid for myelodysplastic syndromes, but changed its mind after Celgene offered a patient-access scheme in August to lower the drug's price.

Imnovid will continue to be offered through the U.K.'s Cancer Drugs Fund. But the fund, which is designed to cover oncology meds stiff-armed by NICE, faces budget constraints of its own and recently axed 25 cancer indications to save an estimated £80 million ($121.3 million) a year.

- read NICE's statement
- get more from PharmaTimes

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