NICE does not recommend Merck’s lung cancer drug

The National Institute for Health and Care Excellence (NICE) has published draft guidance which does not recommend Keytruda, also known as pembrolizumab, for untreated PD-L1-positive metastatic lung cancer.

The committee concluded that the exact size of the overall survival gain for Keytruda compared to current standard of care was uncertain because of the immaturity of the data. Taking into account this uncertainty and the committee’s preferred assumptions for the economic modelling, the committee concluded that the cost effectiveness estimate for pembrolizumab exceeded the range usually considered to be a cost-effective use of NHS resources.

Cost of drug

Pembrolizumab is delivered by intravenous infusion and costs £2,630 for a 100mg vial.

Patient access scheme

Merck, Sharp & Dohme agreed a confidential patient access scheme with the Department of Health which consisted of a simple discount to the list price. There are around 1,500 patients in England who would be eligible for pembrolizumab.

NICE already recommends pemetrexed with cisplatin for adenocarcinoma or large-cell carcinoma and pemetrexed as a maintenance treatment for locally advanced or metastatic non-squamous lung cancer in adults whose disease has not progressed after pemetrexed and cisplatin therapy.

Future of indication

The appraisal consultation document for pembrolizumab is out for public consultation until 21 March.