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Novartis cancer drug beating path to NHS

pharmafile | October 17, 2014 | News story | Sales and Marketing GIST, Glivec, NHS, NICE, imatinib, uturn 

NICE has issued final draft guidance recommending Novartis’s Glivec for up to three years in people who have had a gastro-intestinal stromal tumour (GIST) removed and who are at high risk of the cancer recurring.

In June the UK pricing watchdog performed a U-turn on Glivec (imatinib) by issuing new draft guidance recommending the drug – despite a cost increase. As in its original 2010 review NICE rejected Novartis’s treatment amid concerns of cost-effectiveness.

At the time NICE said it was concerned over a lack of “evidence about key aspects of clinical effectiveness”, including whether the treatment extended life expectancy and how long it should be used for.

Swayed now apparently by further clinical evidence, Professor Carole Longson who is the health technology evaluation centre director, says: “When the original guidance was published, the committee felt there wasn’t enough evidence about key aspects of the clinical effectiveness of imatinib.

“However, the results from ongoing trials have now been published. There is clear evidence that giving imatinib after surgery can delay the recurrence of GIST and in some cases increase survival.”

NICE adds that the findings address several uncertainties, and the body is now happy to recommend Glivec following surgery – as adjuvant therapy – for up to three years for adults who are at high risk of relapse.

This change in guidance comes even though the price of Gilvec has risen from £19,500 per patient per year (400mg) when it was first considered, to £20,700 per year. It has been a surprise blockbuster for the Swiss firm and remains one of its biggest sellers, bringing in $4.7 billion last year.

GISTs are found in the digestive system, most commonly in the stomach and small bowel. Some are benign and cause few symptoms. If they become cancerous and are confined to one area, they can often be removed surgically.

The draft guidance for Glivec is now with consultees who have the opportunity to appeal against it, and until NICE issues final guidance it says NHS bodies should make decisions locally on the funding of specific treatments.

Brett Wells

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