NICE disappointed by Roche's decision on Kadcyla pricing

UK health care cost watch dog the National Institute for Health and Care Excellence (NICE) said this morning that it is very disappointed that Swiss drug pharma major Roche (ROG: SIX), the manufacturer of Kadcyla (trastuzumab emtansine), has decided not to offer its new treatment at a price that would enable it to be available for routine use in the National Health Service.

Kadcyla is currently only available (in England) through the Cancer Drugs Fund. NICE said it wanted to secure the treatment’s long-term future in the NHS by making a recommendation for routine funding from NHS England’s specialised commissioning budget.

Kadcyla treats people with HER2-positive breast cancer that has spread to other parts of the body, cannot be surgically removed and has stopped responding to initial treatment. The treatment is estimated to cost more than £90,000 ($151,550) per patient at its full list price.

In April, NICE published draft guidance that did not recommend trastuzumab emtansine. It concluded that its high price made it impossible for it to recommend despite evidence of its benefits to patients. NICE has now issued final draft guidance reiterating that view.

Proposed price discount insufficient

Sir Andrew Dillon, NICE’s chief executive, said: “Although Roche proposed a discount to the full list price of Kadcyla, it made little difference to its value for money, leaving it well above the top of our specially extended range of cost effectiveness for cancer drugs. We are really disappointed that Roche were not able to demonstrate more flexibility to help us make a positive recommendation. The company is well aware that we could not have recommend Kadcyla at the price it proposed.”

He continued: “Roche considers that the 2014 Pharmaceutical Price Regulation Scheme (PPRS) includes an expectation that NICE will ignore the price a company asks for its product, because the agreement provides for a rebate to be paid by the pharmaceutical industry to the NHS where expenditure on branded drugs rises above an agreed level. The agreement does not contain this expectation because both the Association of the British Pharmaceutical Industry and the Department of Health agree that obtaining value for money from new drugs is in the interests of the industry and the NHS.”