Even at a discount, Sanofi's pricey cancer drug Zaltrap can't win at NICE

Zaltrap--Courtesy of Sanofi

The U.K.'s National Institute for Health and Care Excellence (NICE) has spurned Sanofi's ($SNY) colon cancer treatment Zaltrap once again. And this time, the decision is final. The cost-effectiveness agency dismissed the French company's appeal, despite the offer of a discount.

The bottom line, for NICE, is that Zaltrap is too expensive in a market with plenty of other options. The agency determined that the cost per "quality adjusted life year" for Zaltrap patients would run as high as £66,500 ($109,731). Zaltrap (aflibercept) was developed to treat patients resistant to the chemotherapy drug oxaliplatin.

"We have already recommended six treatments for various stages of colorectal cancer and are disappointed not to be able to add aflibercept as another treatment option for this stage of the disease," NICE chief Sir Andrew Dillon said in a statement. The benefits of the drug would not justify what the country's National Health Service (NHS) would have to pay, he added.

NICE CEO Sir Andrew Dillon--Courtesy of NICE

Sanofi's last-ditch appeal to NICE included a "patient access scheme," or a break on the list price, which normally runs from £295.65 ($488) for 100 mg to £591.30 ($976) for 200 mg, according to Pharmafile. But the discount wasn't enough to push the drug into the realm of what NICE considers cost-effective.

Sanofi noted that NICE's decision ran counter to that of cost watchdogs in Scotland. "We are extremely disappointed NICE has not approved aflibercept, particularly given that based on the same basic evidence, the Scottish Medicines Consortium accepted aflibercept," Steve Oldfield, Sanofi's managing director for the U.K. and Ireland, said in a statement emailed to Bloomberg.

Zaltrap, which Sanofi co-developed with Regeneron ($REGN), has had a tough run since it hit the market in 2012. The drug is an angiogenesis inhibitor, meaning it cuts off the blood supply to tumors, but it's more expensive than similar drugs in the class--and that has hurt its uptake. Memorial Sloan-Kettering Cancer Center in New York, for example, excluded Zaltrap from its treatment protocols, saying the drug had proven no more effective than cheaper rivals, most notably Roche's ($RHHBY) Avastin. That prompted Sanofi to offer discounts in the U.S. Still, analysts expect the drug isn't likely to surpass peak annual sales of $400 million.

- here's the Pharmafile story
- read more at Bloomberg
- here's NICE's statement

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