Pfizer's Ibrance, Novartis' Kisqali go to battle in England after discounts win NICE recommendations

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England's NICE has recommended two CDK 4/6 inhibitors—Pfizer's Ibrance and Novartis' Kisqali—for routine NHS use against a particular type of breast cancer.

Pfizer’s Ibrance may have had a big head start on Novartis rival Kisqali in the U.S. But when it comes to England, new decisions from cost watchdogs have the contenders on more equal footing.

The National Institute for Health and Care Excellence Thursday recommended both breast cancer-fighters for routine use on England’s National Health Service after agreeing to confidential discounts with each drugmaker, the agency said.

RELATED: Can Novartis' Kisqali beat Pfizer's market-leading Ibrance to reimbursement in England?

Now, the drugs will be available for people with HR-positive, HER2-negative forms of the disease, despite “uncertainties” about how long they can actually prolong patients’ lives. They both work by inhibiting cyclin-dependent kinases (CDKs) 4 and 6, which are involved in promoting the growth of cancer cells, the FDA says. 

Ibrance (palbociclib) and Kisqali (ribociclib)which each bear a U.K. list price of £2,950 per cycle, according to NICEhave both shown that they can stall cancer growth by an average of 10 months. But without sufficient discounts, that hadn’t been enough to sway the cost-effectiveness body, which shot down Ibrance in February.

“We are pleased ... that the companies have been able to agree reductions to the price of palbociclib and ribociclib to allow them to be made routinely available to people with this type of breast cancer," Carole Longson, director of the center for health technology evaluation at NICE, said in a statement.

RELATED: NICE fulfills Pfizer exec's prophecy with Ibrance snub

None of these developments surprised Pfizer, whose U.K. medical director of oncology predicted Ibrance would run into reimbursement trouble. In May, the company began doling out the drug free of charge to U.K. patients as it waited for NICE’s final decision.

Now, Pfizer’s hoping those same patients will stick with Ibrance, helping the company leverage its earlier EU approval. Novartis, meanwhile, is likely glad Pfizer’s lead isn’t as wide as it is in the U.S., where Kisqali has managed to grab just 5% of total prescriptions in a market dominated by the blockbuster.