The National Institute for Health and Care Excellence issued draft guidance Thursday recommending routine NHS funding of Pfizer's Ibrance (palbociclib) and Novartis' Kisqali (ribociclib) for people with hormone receptor (HR)-positive, HER2-negative locally advanced or secondary breast cancer. The agency backed use of the CDK 4/6 inhibitors after the companies agreed to provide them at an undisclosed discount and gave more evidence of their effectiveness.
Earlier this year, NICE ruled against use of Ibrance noting that "its cost is too high in relation to its potential benefits." Ibrance was approved in Europe in 2016 for use in combination with an aromatase inhibitor to treat women with HR-positive, HER2-negative locally advanced or metastatic breast cancer, while Kisqali gained clearance in August this year for use in combination with an aromatase inhibitor for the treatment of postmenopausal women with HR-positive, HER2-negative locally advanced or metastatic breast cancer as initial endocrine-based therapy.
According to NICE, "although there are some uncertainties" on how long Ibrance and Kisqali extend life expectancy, the drugs were found to stall the growth of cancer for an extra 10 months on average. The agency added that the appraisal committee also discussed other potential benefits, including reducing the need for chemotherapy.
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Carole Longson, director of the centre for health technology evaluation at NICE, said "the committee heard that by postponing disease progression, [Ibrance] and [Kisqali] may reduce the number of people who are exposed to the often unpleasant side effects of chemotherapy, and delay the need for its use in others." Longson added "we are pleased therefore that the companies have been able to agree reductions to the price…to allow them to be made routinely available to people with this type of breast cancer."
NICE noted that the list price of one cycle of both Ibrance and Kisqali is 2950 pounds ($3884).
For related analysis, read Physician Views Poll Results: Like Kisqali, there is some room for Verzenio in an Ibrance-dominated market.
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