NICE recommends coverage of radium-223, but …


According to a recent report in Pharma Times, the National Institute for Health and Care Excellence (NICE) in the UK is recommending coverage of treatment with radium-223 dichoride (Xofigo) but has changed its mind about coverage of degarelix (Firmagon). The NICE media release making these announcements provides more detailed information about these decisions.

Specifically, NICE’s new draft guidance recommends radium-223 as a potential treatment for men with “hormone-relapsed” (i.e., castration-resistant) prostate cancer that has metastasized to bone and, in particular, for those men who have already received treatment with docetaxel-based chemotherapy. However, NICE also notes that this recommendation is still subject to availability of radium-223 “at a discounted rate.” This last statement seems to imply that negotiations between NICE and the manufacturer of radium-223 (Bayer) are ongoing.

Conversely, having previously suggested a provisional positive recommendation for degarelix (an LHRH antagonist) in the management of patients with signs and symptoms of spinal cord compression, NICE has now determined that using degarelix in this indication at this stage would not be appropriate. Thus, NICE has issued draft guidance against the use of degarelix in the management advanced, hormone-dependent prostate cancer. According to this new draft guidance, NICE states that degarelix

is not a cost-effective drug compared with the currently available standard treatment — LHRH agonists — and there is also no way of identifying the people who would benefit the most from it.

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