2 The technology
2.1 Olaparib (Lynparza; AstraZeneca) is a poly‑ADP‑ribose polymerase (PARP) enzyme inhibitor that selectively kills tumour cells with an impaired homologous recombination DNA repair pathway while sparing normal cells. Olaparib has a marketing authorisation in the UK as 'monotherapy for the maintenance treatment of adult patients with platinum-sensitive relapsed BRCA‑mutated (germline and/or somatic) high-grade serous epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in response (complete response or partial response) to platinum-based chemotherapy'. It is administered orally and the recommended dose is 400 mg twice daily.
2.2 The summary of product characteristics lists the following very common adverse reactions for olaparib: decreased appetite; headache; dizziness; dysgeusia; nausea; vomiting; diarrhoea; dyspepsia; and fatigue. For full details of adverse reactions and contraindications, see the summary of product characteristics.
2.3 The list price of olaparib is £3550 per pack, with each pack containing 448 capsules of 50 mg each (equivalent to 28 days' treatment of 16 capsules per day at continuous full dose of treatment, price excludes VAT, 'British national formulary' [BNF] edition 70). The company has agreed a patient access scheme with the Department of Health, and this was updated after the second appraisal committee meeting. This scheme involves the NHS paying for a patient's treatment with olaparib up to a certain time, with the company providing olaparib free‑of‑charge beyond that point and for as long as each individual patient continues to have olaparib. The Department of Health considered that this patient access scheme would not constitute an excessive administrative burden on the NHS.