Decision to reject vital breast cancer drug is a ‘devastating blow’
A REJECTION by health officials of a breast cancer drug is a “devastating blow” for thousands of women, a charity has said.
The National Institute for Health and Care Excellence (Nice) decided provisionally to not recommend abemaciclib with fulvestrant for routine NHS use as it was not cost-effective.
The combination – used only for patients with a specific type of secondary breast cancer – has been available on the Cancer Drugs Fund (CDF) since 2019. It slowed the disease and delayed the need for chemotherapy.
Breast Cancer Now said it is “deeply concerning” that other patients could be denied the benefits.
Baroness Delyth Morgan, the charity’s chief executive, called the decision not to approve routine NHS use “a devastating blow for thousands of women with incurable secondary breast cancer who could benefit from this innovative treatment in future.
“Crucially, the side effects of this combination treatment...may be more tolerable for some women.
“It’s vital new patients have this treatment option available to them, to help improve their quality of life during the treasured extra months the treatment can give them.”
She said the treatment can help delay onset of the effects of chemotherapy, such as hair loss and cognitive impairment.
Baroness Morgan added: “Abemaciclib with fulvestrant is an example of continued advances in treatment.” Treatment would continue for women with hormone receptor positive HER2 negative secondary breast cancer. But Nice, NHS England and [makers] Lilly UK must work swiftly together to explore all possible solutions to see the decision reversed, including considering more discounts, said the Baroness.
She added: “Unless this happens, patients in future will pay the price of being denied the precious chance this treatment brings to live well longer.”
Taken as a pill twice daily, abemaciclib – also known as Verzenio – is in a class of drugs called CDK4/6 inhibitors, which block proteins in cancer cells that let them divide and grow.
Nice officials said that if the draft recommendation does not change following public consultation, then the treatment will be removed from the CDF upon publication of the final guidance.
New patients would then not have access to abemaciclib via the CDF.
If they wanted it they would have to talk to their doctor about making an individual funding request.
An indirect comparison suggests people on abemaciclib plus fulvestrant have longer before their disease gets worse and live longer than those having an alternative treatment.
Nice staff said some patients in trials had a higher dose of abemaciclib than clinical practice levels, adding uncertainty to how well it may work.
It was unclear for how long people would have the treatment and therefore how much it would cost but the most likely estimates are dearer than the level Nice considers cost-effective.
The treatment normally costs £2,950 for 56 150mg tablets but manufacturer Eli Lilly has agreed a confidential NHS discount.