After initially declining to recommend ZYTIGA for financing in February, NICE has reversed its initial negative draft guidance after public outcry and the offer of a larger commercial-in-confidence discount from JANSSEN. This puts ZYTIGA one step ahead of another recently launched mCRPC therapy – JEVTANA – which received a firm “no” from NICE late last year. Given that both therapies extend overall survival, and both manufacturers offered discounts off of the therapies’ list prices, this differential decision may be due in part to the fact that ZYTIGA is better tolerated than JEVTANA, as well as more convenient due to its oral mode of administration.
This is at least the second time this year that NICE has done a U-turn on its draft appraisal consultation: a similar reversal was seen for GILENYA in March. Are these draft negative guidances just a front for prompting the manufacturer to offer a larger list price discount? That’s what it’s certainly looking like.