Bristol Opdivo discount in kidney cancer changes minds at NICE


In July, England’s cost watchdogs weren’t keen on covering Bristol-Myers Squibb’s Opdivo for kidney cancer patients. But the New Jersey drugmaker has said the magic word: discount.

Friday, the National Institute for Health and Care Excellence announced a flip-flop on the idea, backing the med for NHS use in previously treated patients with renal cell carcinoma--provided Bristol sticks to the already agreed-upon price cut, of course.

It’s good news for the checkpoint inhibitor, which got off to a red-hot start before some recent setbacks brought it down to earth. Earlier this month, the company revealed data from a failed first-line lung cancer trial that doomed the med’s chance in the coveted setting as a monotherapy.

To make matters worse, archrival Merck touted success in first-line for its own contender, Keytruda--and newer nemesis Roche earlier this week snagged a green light from U.S. regulators to take on both meds in the second-line space.

For now, though, Opdivo is the only immuno-onology treatment in the kidney cancer space, though its PD-1/PD-L1 competitors are working on catching up.

That doesn’t mean it’s the only treatment in the kidney cancer space period, though, and it was Pfizer player Inlyta that swayed NICE against recommending Opdivo in the first place. When the watchdog shot Opdivo down this summer, the New York pharma giant had already offered a discount on its treatment that made Bristol’s price tag seem unattractive.

That wasn’t the only issue NICE took with Opdivo, though. At the time, it questioned weather Opdivo’s overall survival numbers from the Checkmate-025 study--in which it bested Novartis’ Afinitor--were “mature,” given the fact that the trial stopped early.

Those concerns haven’t gone away--NICE still cited uncertainties about Opdivo’s survival benefit, and pointed to “very little long-term evidence”--but now, the drug’s price is right, and it can “be considered a cost-effective use of NHS resources.

It’s not the first time Bristol has been able to squeak past the gatekeeper. In June, a cocktail pairing Opdivo and fellow BMS treatment Yervoy won speedy backing from the body in melanoma.

- see the guidance (PDF)

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