Medivation, Astellas sales and marketing update

The U.K.’s NICE issued final draft guidance recommending Xtandi enzalutamide from Astellas to treat hormone-relapsed, metastatic prostate cancer in men who have no or mild symptoms after androgen deprivation therapy has failed and when chemotherapy is not yet clinically indicated -- one of its approved indications. The decision reverses a June draft guidance recommending against Xtandi for the indication after Astellas agreed to a patient access scheme that provides an undisclosed discount to the listed price of L2,734.67 ($4,123) for one 112-pack of 40 mg capsules (see BioCentury, June 22).

Astellas estimated an incremental cost-effectiveness ratio (ICER) of L27,000 ($40,708) per quality-adjusted life year (QALY) gained and the evidence review group estimated L31,600 ($47,643) per QALY gained. NICE recognized that some benefits were not captured in the modeling, such as the value to patients in delaying chemotherapy, that would reduce the ICER to a level that would be considered cost effective. ...