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NICE rejects Keytruda for routine use in NHS bladder cancer treatment

Published on 27/11/19 at 12:46pm

The National Institute for Health and Care Excellence (NICE) has given an initial ‘no’ for Keytruda’s (pembrolizumab) use in treating bladder cancer through the NHS.

The immunotherapy is currently available as a treatment option on the NHS through the Cancer Drugs Fund, and will continue to be until at least January 2020 when NICE will review its initial decision.

NICE said that they could ‘‘not recommend pembrolizumbab’’ due to the incremental cost-effectiveness ratios (ICERs) being ‘‘higher than would normally be considered cost-effective for end-of-life treatments.’’ However, the committee noted that the ranges of ICERs had a ‘‘high degree of uncertainty’’ associated with them.

Rose Gray, Cancer Research UK’s Policy Manager, described the decision as ‘‘disappointing’’ and said: ‘‘We now know that it’s more effective than some other treatments, but we still don’t know how well it works long-term, or whether it’s better than some of the newer treatments which have become available recently. This decision will be reviewed in the new year, so we urge NICE, NHS England and the manufacturer to work together and agree a deal which will mean patients can still access this drug.”

Keytruda was approved for use in the Cancer Drugs Fund in March 2018. This allowed the eligible patients to quickly access the drug through the NHS, while the data was still being collected from the clinical trial on the longer term outcomes.

The drug treats adults with a type of bladder cancer called urothelial cancer. It seeks to enhance the immune system’s ability to recognise and kill cancer cells by blocking a molecule called PD-L1 from interacting with immune cells. It is only an option for people who have already undergone platinum-containing chemotherapy.

Conor Kavanagh

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