NICE recommends Pfizer's Sutent

NICE has issued its final guidance on Pfizer's Sutent, recommending the kidney cancer drug as a first-line treatment.

The drug was initially rejected on cost effectiveness grounds in August 2008 before NICE last month recommended reversing that decision.

"Following extensive consultation, I'm very pleased that we are now able to issue this important guidance in its final form," said NICE chief executive Andrew Dillon.

Sutent (sunitinib) can be used in patients in England who have either advanced or metastatic renal cell carcinoma (RCC), or both - so long as they are suitable for immunotherapy and well enough to tolerate it.

Rob Day, director of Oncology UK at Pfizer, commented: "We are truly delighted that NICE has taken the decision in its final guidance to enable UK patients to benefit from sunitinib, a medicine that has become a standard of care in the rest of the world.

"Not only will this decision have immediate benefits for eligible patients today, but will also pave the way for future treatment advances in kidney cancer."

Sutent can also be considered for RCC patients who are having, or who have had, the current standard RCC treatment of immunotherapy (interferon-alfa or interleukin-2) before these final recommendations.

The company helped seal the deal with a 5% price cut and the offer of one free course of treatment, worth £3,139, to every eligible UK patient.

The company says these moves, in effect since 2007, amount to an average saving of 19-29% per patient for the cost of treatment, depending upon the type and stage of their tumour.

Rival treatments must wait for final guidance

Sutent was initially appraised in RCC with three rival treatments - Bayer's Nexavar, Wyeth's Torisel and Roche's Avastin.

The three rivals were split off from Sutent earlier this year when the evidence available to NICE led it to preliminarily recommend Pfizer's drug but reject the other three treatments.

NICE said this unusual move was to avoid keeping patients waiting for the drug. Its decision is one of the first to be made using the "end-of-life" QALY appraisal, which was designed to make expensive cancer treatments more accessible to patients.

The three rejected drugs still have the chance of being approved at a later date through NICE's consultation and appeal process.

In Wales health boards have been instructed to fund all four drugs since January, provided their prescription is backed by two oncologists, and Macmillan Cancer Support says it will campaign for them to be approved in England too.