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27 January 2016

NICE publishes final drug recommendations for 5 separate medical conditions

NICE – the National Institute for Health and Care Excellence – has published its final recommendations on whether 6 different drug treatments should be routinely funded by the NHS.

Each piece of guidance looked at the cost-effectiveness of a particular drug to treat a specific medical condition.

Olaparib for ovarian cancer

NICE recommends olaparib (also known as Lynparza, and manufactured by AstraZeneca) for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube and peritoneal cancer. The drug is for cancers in adults who have tested positive for the BRCA1 or BRCA2 mutations, and whose disease has responded to platinum-based chemotherapy.

Specifically, the recommendations say that olaparib should be available for people only if they have had 3 or more courses of platinum-based chemotherapy and the drug cost of olaparib for people who remain on treatment after 15 months is met by the company.

Options for prostate cancer

NICE recommends radium 223 dichloride (also known as Xofigo and manufactured by Bayer HealthCare Pharmaceuticals Inc.) as an option for treating adults with hormone relapsed prostate cancer, who;

  • have previously received docetaxel treatment,
  • are experiencing symptoms from the disease spreading to their bones,
  • have no signs of cancer in any other organ.

Radium 223 dichloride is a radiopharmaceutical agent designed to deliver alpha-radiation to cancer that has spread to the bone without affecting the patient’s healthy bone marrow. It is recommended only if it is provided with a patient access scheme discount agreed as part of the appraisal.

NICE recommends enzalutamide (also known as Xtandi and manufactured by Astellas Pharma) as an option for treating people with metastatic hormone-relapsed prostate cancer who have no or mild symptoms after androgen deprivation treatment has stopped working, and before chemotherapy is needed.

The independent appraisal committee concluded that enzalutamide is a well-tolerated treatment that delays chemotherapy (which it recognised as being valuable to patients) and improves survival. It was also found to be cost-effective when provided through the patient access scheme discount agreed.

Panobinostat for multiple myeloma

NICE recommends panobinostat (also known as Farydak and manufactured by Novartis) as a possible treatment for people with multiple myeloma if they have had at least two prior therapies (including bortezomib and an immunomodulatory agent). Panobinostat is recommended only if it is provided with the discount agreed in the patient access scheme.

The decision follows public consultation on a preliminary decision not to recommend panobinostat, with the manufacturer responding to the consultation by submitting a revised economic analysis which allowed the committee to recommend the drug.

Panobinostat is a new type of oral anti-cancer treatment that works by disrupting a key mechanism which causes normal cells to turn cancerous. According to Cancer Research UK, in 2012 there were just over 4,000 new cases of multiple myeloma in England.

Ramucirumab for gastric cancer

NICE does not recommend ramucirumab (also known as Cyramza and manufactured by Eli Lilly and Company) for people whose stomach cancer has spread or if they have cancer that develops at the point where the food pipe joins to the stomach.

The independent appraisal committee concluded that ramucirumab does not provide enough benefit to patients to justify its high cost and did not qualify for end of life considerations, so it was not recommended.

Nintedanib for idiopathic pulmonary fibrosis

NICE recommends nintedanib (also called Ofev and manufactured by Boehringer Ingelheim) for some people with idiopathic pulmonary fibrosis (IPF). Nintedanib is recommended only if it is provided with a patient access scheme discount agreed as part of the appraisal.

People with IPF have damage and scarring to the tissue surrounding the small airways in the lungs. Common symptoms include breathlessness and cough but the condition will steadily worsen and can be fatal. The British Lung Foundation estimates that 5,000 people are diagnosed with IPF every year in the UK.


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Notes to Editors

Further information

  1. NICE guidance is for England only. Once NICE issues its final guidance on a technology, it replaces local recommendations across the country. 
  2. Once NICE issues final positive guidance, the NHS has a legal obligation to begin funding the treatment for eligible patients within 3 months.
  3. People currently taking a treatment which is not in line with the new guidance will not stop receiving it. They have the option to continue treatment until they and their clinicians consider it appropriate to stop.

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