Breast cancer drug rejected by NICE
A breast cancer drug should not be funded by the NHS, the National Institute for Health and Clinical Excellence (NICE) has ruled.
Lapatinib (known as Tyberb) in combination with another drug, capecitabine, is prescribed for women who have advanced breast cancer of a particular type known as HER2-positive breast cancer.
NICE has ruled that it should only be used on the NHS in the context of clinical trials after deciding that it did not represent good value for money compared to existing available treatments. The combined drug cost of lapatinib plus capecitabine is approximately £25,207 a year.
Sir Andrew Dillon, NICE chief executive, said: "The independent Appraisal Committee first began looking at lapatinib for women with previously treated advanced or metastatic, HER2-positive breast cancer in 2007. This has been a long and comprehensive evaluation of the evidence available but only because we want to be sure the decision reached is the right one and made for the right reasons.
"We are disappointed not to be able to recommend lapatinib but evidence suggests it only extends life by a small amount of time - around 10 weeks (2.4 months) - and costs thousands of pounds more than one of the more commonly used NHS treatments for this indication - capecitabine on its own."
The NICE position is currently only at draft guidance stage which means that it can be appealed against before final guidance to the NHS is issued. In the meantime patients may make exceptional case funding requests to their local primary care trust (PCT).
Lapatinib has been licensed for use in combination with capecitabine which means that most private medical insurance companies will fund it, according to the terms and conditions of a member's policy. Bupa, AXA PPP healthcare and Aviva all routinely fund cancer drugs that have been licensed for use but not approved by NICE for NHS funding.
Nearly 46,000 women are diagnosed with breast cancer every year in the UK. It is estimated that, each year, around 2,000 patients with HER2 positive advanced or metastatic breast cancer may be eligible to receive lapatinib.
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