AstraZeneca's Imfinzi gets a lift in lung cancer from England's cost watchdogs

AstraZeneca's Imfinzi bears approvals in stage 3 lung cancer and bladder cancer. (AstraZeneca)

AstraZeneca’s Imfinzi is working to grab sales in a rival-free sector of the lung cancer market, and England’s cost watchdogs just gave it a boost.

Thursday, the National Institute for Health and Care Excellence (NICE) said it would cover the drug on its Cancer Drugs Fund as a treatment for patients with stage 3 lung cancer that can't be surgically removed. The decision puts 165 people in line to receive the immunotherapy in its first year of coverage, the body said.

It’s a win for AstraZeneca, which knows—as its pharma peers do—that getting a drug by NICE can come with its challenges. The cost-effectiveness gatekeeper is known for shooting down new therapies based on price until drugmakers come back with bigger discounts.

AstraZeneca, for its part, did offer up a confidential discount on the immuno-oncology treatment, which bears a list price of £2,466 per 500 mg vial. And while a NICE appraisal committee found data on Imfinzi to be “too immature” to recommend the drug for routine NHS coverage, it passed muster for coverage on the CDF, which was designed to speed access to promising new cancer therapies.

“We are pleased to make this exciting new option available and look forward to seeing further data on the effectiveness of durvalumab,” Meindert Boysen, director of NICE’s Centre for Health Technology Evaluation, said in a statement.

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AstraZeneca surprised Wall Street back in May 2017 with news that Imfinzi had hit its primary endpoint in a trial testing the drug in stage 3 cancer. The results showed “that I-O has a place in nonmetastatic disease,” then-Bernstein analyst Tim Anderson, now with Wolfe Research, wrote to clients. It’s “the kind of breakthrough that promises to pull upward on the I-O market size,” he said.

The British drugmaker went on to win approvals that set it up all alone in the stage 3 market, with rivals—such as Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo—years away from intruding on its territory. And that’s not something AZ can say for Imfinzi’s other indication in bladder cancer, where five checkpoint inhibitors are competing.

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Meanwhile, elsewhere in the lung cancer arena, Imfinzi hasn’t fared as well. Last year, it confirmed investors' worst fears by failing to extend survival in previously untreated non-small cell lung cancer patients, immuno-oncology’s largest market.