UK – NICE U-turn for Kisqali in breast cancer

The National Institute of Health and Care Excellence (NICE) has recommended Novartis’ Kisqali (ribociclib) for use on the NHS in combination with fulvestrant, where exemestane plus everolimus is the most appropriate alternative.

The decision comes just three months after the governing body issued a draft guidance rejecting the drug, citing that “it is not known whether Kisqali increases the length of time people live, because the final trial results are not available yet. Because of the uncertainties in the clinical evidence, and cost-effectiveness estimates that are much higher than NICE normally considers to be an acceptable use of NHS resources, Kisqali with fulvestrant cannot be recommended for routine use in the NHS.”

The decision was made despite clinical trial evidence suggesting that compared with fulvestrant alone, the Kisqali combination increases the length of time before the disease progresses in people with previously untreated advanced disease and in people after a prior endocrine treatment.

After the revised decision, the combination treatment will be available on the NHS with immediate effect, providing approximately 5,300 a year in England and Wales with a new option for their advanced breast cancer…