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UK's NICE gives go ahead for nivolumab for advanced lung cancer

Lung cancer patients in England can now be prescribed nivolumab, also known as Opdivo, after NICE says it should be available through the Cancer Drugs Fund (CDF).

Around 1,300 lung cancer patients will receive nivolumab as part of a CDF deal put forward by makers Bristol-Myers Squibb.

Nivolumab has been widely described as a breakthrough drug. When NICE first reviewed it, they said the evidence was not strong enough to recommend nivolumab for routine NHS use.

However, as nivolumab appeared to be more effective in some patients, NICE asked Bristol-Myers Squibb to make it available with a discount whilst clinical trials were ongoing. In November 2016, two patients submitted petitions with a total of 270,000 signatures urging NICE to approve the drug.

Professor Carole Longson, director of the NICE centre for health technology evaluation said: “We know that nivolumab is clinically effective for some people with lung cancer but the full extent of its benefit is not clear. This new deal means that we can give patients access to what we know is a promising treatment whilst more evidence is gathered on its value.”

Nivolumab works by targeting a protein on the surface of cells. This protein, called PD-L1, is involved in the body’s immune response to cancer. Nivolumab appears to work better in people who have more PD-L1 on their cancer cells.

Professor Paul Workman chief executive of the Institute of Cancer Research, London welcomed the decision: “I’m pleased to see NICE and the drug’s manufacturer showing flexibility in reaching agreement on the drug’s approval.

“Initially the drug was priced far too high to ever have been judged cost-effective by NICE. Companies need to come to the table with their best, most realistic price offer right at the start, so we get new exciting drugs, such as immunotherapies, to patients as quickly as possible.”

Professor Longson added: “In less than a year NICE has recommended five new drugs for CDF use and we have cleared almost all the drugs on the old CDF list for routine use. We are truly delivering on our promise to give patients better access to cancer treatments.”

Nivolumab will now be immediately available to some people with advanced non-small cell lung cancer if they have already been treated with chemotherapy. It is given intravenously in hospital every two weeks.

Exact treatment costs depend on a person’s weight and their type of lung cancer. For example, for someone weighing 73kg, a month’s treatment would cost £5,268.

NICE is looking at nivolumab in many different cancer indications. Each appraisal is independent and will look at the clinical- and cost-effectiveness of the drug compared with what is already available on the NHS in that area.

Nivolumab will also be available to patients in Wales under separate arrangements that will see the drug funded within 2 months.

Source: NICE

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