Press Statement: 6th December 2011
The CML Support Group respond to NICE appraisal committee's Appraisal Consultation Document (ACD) of nilotinib, dasatinib and standard dose imatinib for 1st line use in chronic phase CML.
http://guidance.nice.org.uk/TA/Wave24/15/Consultation/1
1.1 Nilotinib is recommended as an option for the first-line treatment of chronic phase Philadelphia-chromosome-positive chronic myeloid leukaemia (CML) in adults if the manufacturer continues to make nilotinib available with the discount agreed as part of the patient access scheme.
1.2 Standard-dose imatinib is recommended as an option for the first-line treatment of adults with chronic phase Philadelphia-chromosome-positive CML.
1.3 Dasatinib is not recommended for the first-line treatment of chronic phase Philadelphia-chromosome-positive CML
As expected the Committee has recommended nilotinib, providing the patient assistance scheme (a confidential discount on the published price) as offered by Novartis remains operative. They also recommend standard dose imatinib. CMLSg welcomes this.
However, we remain disappointed that dasatinib is NOT recommended.
CMLSg will respond to the ACD before the deadline of 10th January 2012, but we await with interest the publication of the Appeal Panel judgemnt on the appeal against the FAD which did not recommend the use of dasatinib for 2nd line use in imatinib resistant and/or intolerant CML in chronic stage, or for accelerated and blast phase CML.
Using the NICE timelines as guidance, the Appeal Panels' judgement will likely be published in the same week as the deadline for comments on the ACD published today.
CMLSg will wait until the Appeal Panels' judgement on our grounds for appeal is published before we consider launching any concerted campaign activity.
The NICE Appraisal Committee has accepted that both dasatinib and nilotinib are equally effective and that both are a tangible improvement on standard dose imatinib. We therefore can only conclude that the latest decision not to recommend dasatinib has everything to do with its price and nothing to do with its clinical efficacy.
Both TKIs are expensive, just as imatinib was once considered to be. As tax payers as well as potential consumers, we would like all the goods we buy to be cheaper, in order to make our pounds go further in this time of greater economic austerity.
However, Rolls Royce drugs come with equivalent prices. The issue for us is this, do we accept their use for the 1% who can afford the Rolls Royce rather than for the 99% who cannot?
We think we know the answer.