NICE fulfills Pfizer exec's prophecy with Ibrance snub

England's cost-effectiveness gatekeepers say Pfizer's Ibrance is too expensive for routine NHS use.

Late last year, a Pfizer U.K. exec predicted breast cancer hot-shot Ibrance would run into trouble with England’s cost watchdogs. And now, his fears have been realized.

Friday, the National Institute for Health and Care Excellence (NICE) shot down the drug in draft guidance, citing its price—£79,650 ($99,392) for a full course of treatment—as too high for routine NHS use.

The committee was well aware of Ibrance’s clinical benefits when making its decision, Carole Longson, director of NICE’s center for health technology assessment, said in a statement. It heard from a patient expert that “delaying the progression of their cancer for as long as possible and being able to continue with normal activities, including working, is valued very highly by patients and their families,” and that Ibrance may also reduce the number of patients exposed to negative chemo side effects.

Still, though, while NICE found it “likely” that Ibrance’s average 10-month progression-free survival extension would result in an overall survival benefit, it couldn’t specifically quantify it with available clinical trial data. And even if it could, it still wouldn’t be “enough to make palbociclib cost effective at its current price,” NICE said.

Pfizer did not immediately respond to a request for comment.

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While it’s bad news for the New York drugmaker, it’s bad news that may not be all that surprising. Back in November, David Montgomery, Pfizer’s U.K. medical director of oncology, expressed concerns about NICE’s Ibrance review. The body’s methodology—which classified Ibrance, approved in combo with an aromatase inhibitor, as an “add-on” med—put the product in a poor position to gain coverage, he quipped.

Pfizer still has time to turn the verdict around, though. The company—along with healthcare professionals and members of the public—can comment on the recommendation until Feb. 24. And as the pharma giant well knows, NICE can often be swayed with a discount; last summer, NICE reversed a decision in Pfizer’s favor, agreeing to cover Bosulif under its controversial Cancer Drugs Fund.