02 December 2016

NICE recommends new lung cancer drug pembrolizumab

Hundreds of people with advanced lung cancer will now have access to new drug pembrolizumab, also known as Keytruda, after NICE recommends it for routine NHS use.

Pembrolizumab works by targeting a specific protein on the surface of cells which is involved in the body’s immune response to cancer.

In draft guidance NICE has said that adults with advanced lung cancer, that test positive for this protein, should have access to pembrolizumab.

Professor Carole Longson, director of the NICE centre for health technology evaluation said: “People with advanced non-small-cell lung cancer have had limited treatment options so it is great that pembrolizumab will now be routinely available. The company put forward a fairly priced proposal that reflected the benefits their drug offered.

“If companies work with us to price drugs reasonably and manage any uncertainties in the evidence base, we can continue to recommend patients have routine access to the treatments they need.”

Earlier this year, NICE’s appraisal committee did not recommended pembrolizumab as there were uncertainties about its long-term benefits. This was reversed when Merck, Sharp & Dohme who market the drug, presented newer data and also offered a further discount on the drug.

It was also agreed that the drug should be used and then stopped at two years if a person’s disease has not worsened.

Further data on the effectiveness of pembrolizumab is expected soon and NICE will review its guidance when this is available.

Pembrolizumab blocks the activity of a protein known as PD-L1 which is produced in larger amounts on cancerous cells than normal cells. By blocking PD-L1 it helps the person’s own immune cells to attack the cancer.

The drug is used if people have already been treated with at least one other chemotherapy. It is given by injection every 3 weeks.

The average cost of a course of treatment with pembrolizumab is £29,114 at its full list price but the company offered the NHS a confidential discount.

Around 1,700 people in England with non-small-cell lung cancer are expected to be eligible for treatment with pembrolizumab.

Although this a draft recommendation, changes to the Cancer Drugs Fund mean that pembrolizumab will immediately be funded by NHS England.

If companies work with us to price drugs reasonably and manage any uncertainties in the evidence base, we can continue to recommend patients have routine access to the treatments they need.

Professor Carole Longson, director of the NICE centre for health technology evaluation