For AstraZeneca and Merck's Lynparza in prostate cancer, a first-in-class approval isn't a guarantee for reimbursement in England.
Following a negative draft guidance, the National Institute for Heath and Care Excellence (NICE) has decided not to recommend Lynparza for NHS coverage in BRCA-positive prostate cancer. The England and Wales drug cost watchdog deemed the PARP inhibitor “not cost-effective at its current price.”
The indication, in metastatic BRCA-positive prostate cancer following prior hormonal therapy, has already been rejected twice by NICE, both because of cost issues.
The decision was met with disappointment, with the Institute of Cancer Research saying that ‘double counting’ the costs acts “as a penalty for innovation.” NICE said that the drug could be reviewed again under a revised price.
NICE's verdict has also created a rift within the U.K. A year ago, the Scottish Medicines Consortium has recommended that use of Lynparza for Scottish men.
In 2019, the drug scored NICE recommendation with use via the Cancer Drugs Fund, with a discount for maintenance treatment of advanced BRCA mutation-positive ovarian cancer after chemotherapy, allowing patients to apply for CDF approval for the drug at its discounted price.
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