NICE Urges Gilead Reduce Trodelvy Price, Bans Eczema Drugs

The United Kingdom’s drug price watchdog had a bad week. The National Institute of Health and Care Excellence has denied Gilead Sciences’ Trodelvy for usage against triple negative breast cancer in preliminary recommendations, claiming that it is too expensive for the NHS to utilise.

The National Institute for Health and Care Excellence (NICE) has dismissed three atopic dermatitis drugs—Rinvoq from AbbVie, Pfizer’s Cibinqo, and Leo Pharma’s Adtralza—in a separate ruling. According to NICE, the decision has no impact on patients who are currently receiving the therapy. Firstly, when it comes to Trodelvy, the guidance establishes a coverage gap with Scotland, which has approved the treatment. Trodelvy has been demonstrated to survive longer than chemotherapy in triple-negative breast cancer (TNBC) patients.

The draft guidance is followed by a three-week public feedback period. Meanwhile, Gilead has been given the task of lowering Trodelvy’s price by NICE. They are taken aback since this price signifies they cannot stress it for use in the NHS at this time, given the dearth of therapy choices for women with this form of breast cancer, said Helen Knight, interim head of medicine evaluation at NICE, in a statement. They hope the corporation will think about what it can do to help NICE approve a treatment that could allow patients with significant triple negative breast cancer to spend more time with their loved ones.

According to NICE, 2,000 women in England have TNBC, with 650 of them being eligible for Trodelvy if they are cleared. The use of Roche’s Tecentriq in combination with chemotherapy is recommended by NICE for TNBC. Gilead described the decision as “very disappointing,” adding that the United Kingdom is really the only Project ORBIS nation that does not cover the treatment. Gilead stated that it would engage with NICE to reach an agreement before the May 10 conference.

Gilead will work closely with NICE to resolve doubts raised about cost-effectiveness estimates, according to the company. They feel they have made a compelling, cost-effective case for SG reimbursement in England, and that they are genuinely worried about the possibility of unnecessary delay, particularly in a cancer case where every day counts. NICE says there is ambiguity about the efficiency of atopic dermatitis medications as compared to other authorised topical therapies such as lotions and corticosteroids. Immunosuppressants like methotrexate and ciclosporin, as well as targeted treatments like Sanofi’s Dupixent and Lilly’s Olumiant, are also approved for use.

Due to the shortcomings in clinical data, the economic model’s findings are also highly unclear, NICE noted. As a result, determining the cost-effectiveness of the medications is difficult. NICE has asked for further information in order to analyse cost effectiveness, and will meet next month to do so.