NHS: Breast cancer drug U-turn after manufacturer agrees discount

A breast cancer drug rejected by the NHS earlier this year has now been recommended by health officials after a discount in pricing was agreed with the manufacturer.

The charity Breast Cancer Now says women might now have "precious extra months" with loved ones and calls the U-turn "fantastic news".

The National Institute for Health and Care Excellence (Nice) has published draft guidance recommending abemaciclib, given with fulvestrant for hormone receptor-positive, HER2-negative breast cancer which has spread to other parts of the body in adults who have had endocrine therapy.

In February, Nice decided to provisionally not recommend it for routine use in England, because it had not been found to be a cost-effective use of NHS resources.

But the organisation said its latest decision follows an improved patient access scheme from the drug’s maker, Eli Lilly, which will offer it at a discounted rate.

Nice said that, along with further economic modelling data provided by the company, abemaciclib – a twice-daily pill also known by the brand name Verzenios – can now be recommended.

It is usually priced at £2,950 for a packet of 56 tablets, but Nice said Eli Lilly has agreed a confidential NHS discount.

Nice said it had also heard, during consultation, of the value to patients of having abemaciclib as an alternative treatment option with different side-effects.

Meindert Boysen, director of the centre for health and technology evaluation at Nice, said drugs like abemaciclib are welcomed by patients with incurable advanced breast cancer “because they can delay the time before their cancer gets worse and so delay or avoid the need for chemotherapy”.

He said: “The committee also heard from the patient experts that exemestane plus everolimus, the treatment that would normally be used at this stage, was poorly tolerated and used for only a small number of people because it has similar effects to chemotherapy on quality of life.

“We are therefore very pleased to be able to recommend that abemaciclib with fulvestrant can now be provided routinely as another option for people with advanced breast cancer who have already had endocrine therapy.”

Baroness Delyth Morgan, chief executive at the charity Breast Cancer Now, which worked to urge a reversal of the decision, said the approval is “fantastic news”.

She said: “Following its worrying provisional rejection by Nice earlier this year, this decision now secures its future use on the NHS, bringing hope to eligible women who could see this combination treatment offer them precious extra months before their disease progresses, and it could even help extend their lives.”

She said the drug could help women “have the best quality of life possible in these extra months with side-effects that may be more tolerable for some women than those of other CDK 4/6 inhibitors available on the NHS”.

She added: “This treatment can also delay the need to start chemotherapy and enduring its debilitating side-effects.”

The decision applies to England and Wales and Nice said its final guidance on the drug will be given in September.