The U.K.'s cost-effectiveness watchdog certainly doesn't shy away from controversy. The National Institute for Health and Clinical Excellence has moved to limit the use of Novartis and Bristol-Myers Squibb's leukemia drugs, saying the expensive drugs' benefits aren't worth the cost. The question now is whether the companies will try to cut a deal with NICE, trading discounts or money-back guarantees for access to National Health Service patients.
NICE has nixed certain uses on an array of pricey cancer drugs, including Roche's Avastin and Tarceva, GlaxoSmithKline's Tyverb and Pfizer's Sutent, as well as Nexavar, from Bayer and Onyx Pharmaceuticals. "When we recommend the use of very expensive treatments, we need to be confident that they bring sufficient additional benefit to justify their cost," NICE director Sir Andrew Dillon said in NICE's latest statement.
Some drugmakers have been able to change the agency's mind with discounts and risk-sharing deals. Pfizer, for instance, won the nod for Sutent by offering the first treatment cycle for free; it would usually cost upwards of $4,000. Johnson & Johnson got the OK after it agreed to rebate the cost of its blood cancer drug Velcade if patients didn't respond to the med. However, some companies are reluctant to offer discounts because they might face pressure to offer the same cost-sharing deals in other countries, as the Wall Street Journal notes.
The new CML guidance isn't final. The agency plans to review comments in June and issue another draft guidance after that. Over the next few months, we can expect lobbying from patient groups and from the companies. BMS' press release about the NICE ruling includes comments from a patient-advocacy group, the WSJ points out. Whether Novartis and BMS will counterbid remains to be seen.