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Merck's Keytruda suffers rejection at hands of NICE

Published on 05/10/16 at 12:02pm

NICE rejected Merck’s Keytruda, a treatment for advanced non-small-cell lung cancer (NSCLC), on the basis that the drug was not cost efficient. In the submission to NICE, the company assumed that patients would stop using Keytruda at two years if their disease had not gotten worse. NICE’s appraisal committee countered that, in real-life clinical practice, it would be unlikely that any patient who was benefiting from the treatment provided by the drug would willingly stop taking it.

Carole Lonson, director of the centre for health technology evaluation at NICE, commented that "Even when making assumptions about the value of using pembrolizumab beyond two years, our lowest estimates showed it would be over the range of what we normally consider cost-effective," According to the Institute's calculations, the most plausible ICER for Keytruda would exceed £50,000 per QALY gained.

Around 1,700 people affected by NSCLC would be available for treatment in the following year. Its list price is £29,114 for an average course of treatment but this does not take into account any confidential discount that may have been proposed to the NHS.

Louise Houson, UK Managing Director of MSD (Merck’s non-North American name), released a statement saying: "We are working with both NICE and NHS England to ensure we can find a solution to get back on track and make sure this much needed treatment option is made available to people with previously treated advanced NSCLC as quickly as possible…This is particularly important as these patients have a very poor prognosis, with limited time."

Ben Hargreaves

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