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Faslodex rejected by NICE for NHS breast cancer use

Published on 02/02/18 at 10:31am

Bad news for breast cancer patients in the UK as the National Institute for Health and Care Excellence announces it has decided to reject AstraZeneca’s Faslodex (fulvestrant) on the basis that it cannot reconcile its cost-effectiveness for use on the NHS.

AZ had been hoping to secure the drug’s routine use on the health service in the treatment of locally advanced or metastatic oestrogen-receptor positive breast cancer in postmenopausal women who have not undergone prior endocrine therapy.

Despite Phase 3 data demonstrating that patients experienced significantly longer progression-free survival while using Faslodex than anastrozole , at 16.6 months versus 13.8 months, NICE said that final data on the drug’s efficacy cannot be determined until the trial ends at the end of next year. As a result, accurate representations of the drug’s efficacy compared to aromatase inhibitors are elusive and its cost-effectiveness is uncertain, though the organisation judged that its price per QALY “is likely to be above the range normally considered a cost-effective use of NHS resources.”

“There is a need for more effective treatments for locally advanced or metastatic breast cancer to delay the need for chemotherapy and to extend survival. But NICE has to ensure that the NHS provides treatments that bring benefits which are value for money,” said Professor Carole Longson, director of the centre for health technology evaluation at NICE. “As fulvestrant has not been shown to be cost-effective, we can’t justify diverting NHS funds from other areas of healthcare in order to fund its use.”

The drug was approved for as a first-line treatment for breast cancer in Europe in July last year.

Matt Fellows

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