NICE has today refused to approve tykerb for general use in advanced breast cancer…despite the manufacturers saying they would pay for first three months of treatment. (why not offer to cut the price if you’re that bloody confident??)
Tykerb is used together with the chemotherapy drug xeloda in the treatment of her2+ advanced breast cancer when herceptin has failed. Unfortunatley data from trials has not been as promising as hoped for. There will probably be an appeal and another review later in the year when more trial evidence avaialble.
I know most cancer patients get very angry indeed about NICE refusing to approve any cancer drugs…I’m more quirky about it and sometimes think there’s an unwarranted despertaion in that idea. Today Breakthrough’s bland press release response to the news is hardly going to inspire anyone.
As I’m not her2+ don’t know a lot about tykerb. Would love to know what you think ChristineMH if you’re around.
Jane
Hi Jane,
This one is one of those cases where the drug works in that it adds a few months on average, but hasn’t yet demonstrated spectacular enough results to justify the price tag in NICE’s eyes. NICE estimated that the quality adjust life year added was quite high (around £80,000, I vaguely recall). NICE expects drugs to come in at £20,000-£30,000 per QALY. I suspect that they don’t want to cut prices too much because lapatinib is a pill and therefore more vulnerable to being shipped covertly into the high-price U.S. market (where insurance companies have been willing to pay up to 200,000/QALY at times). That market is really where the pharmaceutical companies regain their investments.
Lapatinib could still turn out to be a good drug, but it is much more likely to become part of an eventual treatment against primaries than against secondaries, simply because it is so much easier to give primary patients years more of life, which would justify the costs.