England’s cost-effectiveness watchdogs are influential arbiters in the drug-reimbursement world. Other countries often look to the National Institute for Health and Care Excellence when making their own decisions about which drugs to cover.
They’re also notoriously tough on expensive cancer drugs.
Consider NICE’s latest draft guidance: The agency says it’s not inclined to cover Opdivo, the Bristol-Myers Squibb immuno-oncology treatment, for non-small cell lung cancer. The med has some solid effectiveness data backing its use, including overall survival results that reportedly impressed the FDA into approving it ahead of schedule.
Indeed, in its appraisal documents, NICE acknowledged that Opdivo was better at extending patients’ lives than standard treatment with docetaxel, and that Opdivo came with fewer side effects than chemotherapy treatments. The agency said that treatment options for NSCLC patients who’ve failed on prior therapy are few.
Bristol-Myers also offered a cost-sharing deal: England’s National Health Service would pay for 26 weeks of treatment, or about £31,000 ($45,000). The next 26 weeks, if needed, would be covered by the company.
Still, NICE considered Opdivo too expensive for the benefits it confers. When its cost is calculated alongside its survival advantage over docetaxel, Opdivo cost £91,100 per quality-adjusted life year (QALY), which is a common measure of cost-effectiveness, the agency said.
The upshot? Opdivo is a “clinically-effective treatment option” for previously treated patients with NSCLC, but “the committee did not recommend nivolumab as a cost-effective use of NHS resources.”
This is a draft guidance, and NICE will be collecting comments on its assessment through June 3. NICE has recommended Opdivo for advanced melanoma. Its head-to-head competitor, Merck & Co.’s Keytruda, is also recommended for melanoma, and has not yet been assessed by NICE in lung cancer.
- see the NICE document
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