NICE rebuffs Zytiga

The U.K.'s NICE issued draft guidance recommending against Zytiga abiraterone from Johnson & Johnson (NYSE:JNJ) in combination with prednisone or prednisolone in patients with metastatic, castration-resistant prostate cancer (CRPC) that has progressed on or after docetaxel-containing therapy -- the drug's approved indication. According to the committee, the treatment would not be cost-effective, even with a patient access scheme under which J&J would provide the drug at an undisclosed discount. The committee said the incremental cost-effectiveness ratio (ICER) for Zytiga plus prednisone vs. prednisone alone is L63,200 ($99,053) per quality-adjusted life year (QALY). Additionally, NICE said that while Zytiga can extend life by more than three months compared to placebo, the drug did not meet the criteria for a life-extending, end-of-life treatment because the patient population cannot be considered small. Comments are due Feb. 23.

In a statement, Cancer Research U.K. said Zytiga's treatment population -- estimated to be about 3,300 in 2011 -- is small enough to be considered an end-of-life treatment. The committee responded in a statement that there is no set threshold cost for drugs that meet the end-of-life criteria, but noted that the highest cost per QALY of a recommended drug has been L50,000. Cancer Research U.K. participated in abiraterone's development and is eligible for royalties. ...