Eli Lilly's Portrazza turned away in final NICE guidance


Months after an initial rejection for lung cancer newcomer Portrazza, Eli Lilly ($LLY) has been told a final “no” by England’s cost-effectiveness watchdogs. NICE recommended against use of the med, saying Portrazza is “innovative,” but can’t be considered a “life-extending, end-of-life treatment.”

In trials, Lilly’s drug--plus the chemo combo gemcitabine and cisplatin--showed not quite two months of additional survival on average. But it would cost £110,000 ($142,000) to £170,000 ($220,000) per quality-adjusted life year, NICE said, and likely “toward the upper end of this range.” The watchdog said it deemed Portrazza not “a cost-effective use of NHS resources.”

“The independent appraisal committee acknowledged that necitumumab provides small improvements in overall survival, however it cost too much compared to combination chemotherapy,” according to a NICE spokesperson.

An average treatment course with Portrazza runs £30,740 ($39,882), NICE said. Lilly offered a “simple discount” that wasn’t disclosed.

Lilly’s Portrazza won approval in Europe earlier this year in advanced non-small cell lung cancer after Phase III data demonstrated the drug plus gemcitabine and cisplatin extended patients’ lives over just gemcitabine and cisplatin. Patients in the Portrazza arm lived a median of 11.5 months versus 9.9 months for the gemcitabine plus cisplatin group.

Taking into account its cost-effectiveness, plus the fact that there were “no clinical uncertainties that could be addressed by collecting outcome data from people in the NHS,” Portrazza didn’t meet requirements for inclusion in the special Cancer Drugs Fund, NICE said.

Portrazza’s price has been highlighted in the past, with a JAMA Oncology article last year saying the med should cost $9,600 less per month. At the time, the authors said the drug extends life expectancy by weeks, and in about half of patients.

For Lilly, the NICE rejection comes as the Indianapolis-based drugmaker leans on new launches to drive growth. In Q2 results, the company reported a 9% sales increase over the same period last year, saying at the time that it expects at least 5% growth through 2020 from volume and margin increases.

Also this week, NICE gave a thumbs up to Bayer’s prostate cancer med Xofigo and Amgen’s ($AMGN) new oncolytic viral therapy, Imlygic.

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