The 3 separate pieces of guidance each look at the cost-effectiveness of a particular drug to treat a specific medical condition. They cover pancreatic cancer, a type of leukaemia and kidney disease.
Nab-paclitaxel for the treatment of pancreatic cancer
NICE has confirmed in final guidance that nab-paclitaxel (marketed as Abraxane by Celgene) should not be routinely funded on the NHS for pancreatic cancer. NICE looked at how well nab-paclitaxel, given with gemcitabine, works for people whose pancreatic cancer has spread and who have not received any other treatments. NICE concluded that the cost of using nab-paclitaxel is not justified by its limited benefits compared to current treatments.
Sir Andrew Dillon, NICE chief executive, said: “We recognise that the development of new treatments for pancreatic cancer has been limited in recent years. Nab-paclitaxel is a new treatment but we must still carefully weigh up the benefits it can offer, particularly as there are comparable options already available in the NHS. Although it is more effective than one of the treatment options currently available, nab-paclitaxel is linked with more side effects. When we consider how these side effects will affect each individual and the fact that it is also more expensive, nab-paclitaxel cannot be considered an effective use of NHS resources.”
Idelalisib for the treatment of chronic lymphocytic leukaemia
NICE recommends idelalisib (marketed as Zydelig by Gilead Sciences) when used in combination with another cancer treatment rituximab to treat adults with chronic lymphocytic leukaemia who have 1 of 2 genetic changes (17p deletion or TP53 mutation) and have not received any other treatment. Any adult with the disease whose cancer has returned less than 2 years after previous treatment is also eligible for treatment with idelalisib and rituximab combined.
The guidance stipulates that idelalisib can only be prescribed if the company provides the drug at a pre-agreed discounted rate.
Tolvaptan for the treatment of kidney disease
NICE recommends tolvaptan be made available for treating autosomal dominant polycystic kidney disease (ADPKD) in adults with stage 2 or 3 chronic kidney disease at the start of treatment and with evidence of rapidly progressing disease. Tolvaptan (marketed as Jinarc by Otsuka Pharmaceuticals) is a treatment option for slowing the progression of cyst development and helping protect renal function.
The guidance also stipulates that tolvaptan can only be prescribed if the company provides the drug at a pre-agreed discounted rate.
For people with pancreatic cancer who are currently receiving nab-paclitaxel, or those who are being treated with idelalisib or tolvaptan in whom the drugs are not recommended by the new guidance, NICE says treatment should continue until those having the drug and their doctor consider it appropriate to stop.
Where NICE recommends a treatment, the NHS is legally obliged to begin funding the drug within 3 months of the final publication date.
For more information on any or all of the published guidance mentioned, call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.
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