- NICE says NHS can't afford Roche's Kadcyla in final decision
- Patients taking Kadcyla don't have to stop taking it
Roche Holding AG failed to win the endorsement of the U.K.’s health-cost regulator for its breast-cancer medicine Kadcyla, capping two years of haggling over the cost of the treatment.
In final guidance to the state-run health system, the National Institute for Health and Care Excellence said the Roche drug is too expensive at about 90,000 pounds ($136,300) per patient. The decision not to fund Kadcyla comes after consultations with patient groups and doctors as well as representatives of the Basel, Switzerland-based company, starting in December 2013.
Roche said Wednesday that it’s willing to offer a bigger discount so that the 1,200 Britons estimated to be eligible for Kadcyla could receive it through the National Health Service. The NHS relies on the regulator known as NICE to help determine which therapies offer good value for money. The world’s biggest cancer-drug maker, under pressure to lower the cost of the drug, had proposed a discount, but it wasn’t big enough, NICE said Wednesday in a statement.
“We are prepared to offer the same discount that was required to retain Kadcyla” on the Cancer Drugs Fund, a separate funding source that makes available some of the expensive treatments that haven’t been recommended by NICE, Roche said. “We are willing to be collaborative and continue discussions with NICE to ensure that Kadcyla remains available to patients in England with advanced breast cancer for the long term.”
Roche shares rose 1.2 percent to 271.50 Swiss francs at 2:31 p.m. in Zurich. The stock has fallen 3.5 percent in the last year.
In September, Roche Chief Executive Officer Severin Schwan blasted a U.K. decision to stop paying for Kadcyla and its cancer blockbuster Avastin through the cancer-drug fund, calling the choice “stupid” and “completely arbitrary” because it focuses on the price of medicines rather than potential savings to the health system.
Kadcyla is used for a type of breast cancer with a genetic mutation known as HER2 that has spread to other parts of the body, can’t be removed with surgery and no longer responds to the initial treatment. It combines Roche’s older drug Herceptin with a technology that helps the medication carry chemotherapy directly into malignant cells while bypassing healthy ones.
The product almost doubled the delay in disease progression compared with Herceptin alone in one study, allowing patients to live a median of 6.2 months longer without their cancer worsening. Kadcyla will generate about 780 million Swiss francs ($788 million) in sales this year, and more than 1 billion Swiss francs next year, according to analysts’ estimates. The medicine is reimbursed in 16 European countries including Greece and Italy, according to Roche.
“This guidance does not mean that people currently taking Kadcyla will stop receiving it,” NICE said. “They have the option to continue treatment until they and their doctors consider it appropriate to stop.”
Kadcyla is the eighth consecutive therapy for advanced breast cancer that hasn’t been recommended by NICE since 2011, according to Roche. Cancer treatments, because of their high costs, often fail to win NICE’s backing unless the manufacturers offer discounts or other incentives that make the products less costly to the NHS. This month, NICE recommended AstraZeneca’s Lynparza ovarian cancer therapy and Astellas’s Xtandi for prostate cancer, while it didn’t recommend Johnson & Johnson’s Zytiga for prostate cancer in preliminary guidance.
The U.K. has a lower overall survival rate for cancer than other European countries, about 50 percent, according to an analysis presented at the European Cancer Congress this year. That compares with 59.6 percent in Northern Europe, 58 percent in Central Europe, and 54 percent for Southern Europe, and is on par with the Czech Republic, at 51 percent. Contributing to the U.K.’s low survival rate is a poor record of early diagnosis, and NICE published guidelines this year to improve detection.