Six months after England’s National Institute for Health and Care Excellence (NICE) spurned Pfizer’s breast cancer treatment Talzenna (talazoparib) because it was not cost effective, the agency has reversed course following the company’s offer to slash the price.
Pfizer originally priced Talzenna at £4,965 ($6,296) for a 30-pack of 1 mg capsules and £1,655 ($2,099) for a 30-pack of 0.25 mg capsules, leading to its rejection in previous draft guidance. The new discounted price is confidential.
“When considering the condition’s severity and its effect on quality and length of life, the most likely cost-effectiveness estimates for talazoparib are within the range that NICE considers an acceptable use of NHS resources. So talazoparib is recommended,” NICE wrote in its draft guidance.
In the United States, Pfizer charges list prices of $19,005 and $6,341 for the two 30-packs, according to Drugs.com. Talzenna was approved in the U.S. for breast cancer in 2018 and as a combo treatment with Astellas and Pfizer’s Xtandi for prostate cancer in June of last year.
The NICE rejection, in July of last year, left secondary breast cancer patients in the U.K. with the inherited germline BRCA mutation without a targeted treatment option. Roughly 5% to 10% of women with breast cancer have the altered gene.
NICE's new recommendation covers adults with HER2-negative, locally advanced or metastatic breast cancer with germline BRCA1 or BRCA2 mutations after prior chemotherapy.
In the EMBRACA trial, Talzenna increased how long patients lived without their cancer progressing compared to chemotherapy (8.6 months versus 5.6 months) at a median follow-up of 11.2 months. The trial did, however, not show any difference in how long patients lived.
“Because talazoparib is taken as a once-daily tablet it means it’s much more convenient for people who would otherwise need to go into hospital for intravenous chemotherapy,” Helen Knight, NICE’s director of medicines evaluation, said in a release. “Although some uncertainty in the clinical evidence remains, when considering the impact of advanced breast cancer and its effect on quality and length of life, the improved discount from the company means we can now recommend talazoparib for us in the NHS.”
While NICE will publish final guidance on talazoparib next month, it nevertheless becomes available immediately under an interim funding arrangement. There are approximately 300 patients in England who will become eligible to receive the treatment.