England stiff-arms Roche again as NICE rejects Perjeta


England’s cost-effectiveness gatekeepers often shoot down pricey cancer therapies for use on the National Health Service on the grounds that they can’t pinpoint a med’s value--and Roche’s Perjeta couldn’t escape that trend.

Thursday, the body said in draft guidance that the long-term benefits of the breast cancer-fighter were “too uncertain” to warrant its backing. While evidence showed that adding the med to Roche’s Herceptin and docetaxel successfully upped the cocktail’s ability to rid patients of cancer before surgery, there wasn’t enough to convince NICE that “this would reduce the risk of the disease recurring and result in longer survival.”

It’s a blow to Roche, which is counting on Perjeta and a handful of other next-gen cancer meds to generate sales as its trio of oncology blockbusters--Herceptin, Avastin and Rituxan--ages. In Q1, Perjeta teamed with fellow breast cancer therapies Herceptin and newcomer Kadcyla to push sales for the period up by 4% in constant exchange rates; on its own, it saw a 33% sales swell over the year-ago quarter.

But it’s far from the first time the Swiss drugmaker has felt the sting of English cost watchdogs’ decision-making. Last September, the U.K.’s special Cancer Drugs Fund punted Kadcyla and a slate of other treatments, prompting outrage from Roche and other drugmakers. "It's stupid from a cost point of view," CEO Severin Schwan said at the time. "How the hell can you ignore all these benefits?" 

Since then, the fund has agreed to cover Kadcyla in one form of breast cancer, but NICE has also refused to cover the drug in the general population, even with a discount.

Roche, meanwhile, has switched to a more conciliatory tone in the wake of all the strong-arming. In April, it signaled that it was open to price negotiations--and even money-back guarantees--to snag coverage for some of its products.

And luckily for the Basel-based company, it has up-and-coming meds in different areas to back it up. Earlier this week, it won a fast FDA approval for PD-L1 blockbuster contender Tecentriq, which will now take on fellow checkpoint inhibitors Keytruda from Merck and Opdivo for Bristol-Myers Squibb as the trio race to pick up additional indications. And analysts expect multiple sclerosis prospect ocrelizumab--which has shown promise in a hard-to-treat form of the disease--to come on strong when it hits the market, too.

- read NICE's release

Special Report: Top 10 best-selling cancer drugs of 2013

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