The National Institute for Health and Care Excellence (NICE) has published final draft guidance for Takeda's lung cancer treatment brigatinib (brand name Alunbrig) for treating liver cancer.
NICE state that 'brigatinib is recommended, within its marketing authorisation, for treating anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC) in adults who have already had crizotinib. It is recommended only if the company provides it according to the commercial arrangement.'
Commercial arrangements are agreements between the manufacturer and the NHS, usually specifying a set of conditions under which reimbursement for the medicine will be made.
This means that Alunbrig will be available for use by NHS England and Wales when the determination is published in March 2019.
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Why the committee made these recommendations
People with ALK-positive advanced NSCLC that has been treated with crizotinib are currently offered ceritinib as their next treatment.
Clinical evidence based on indirect comparisons of trials suggests that people having brigatinib live longer than those having ceritinib, and that they live longer before their condition worsens. Brigatinib may be more effective for brain metastases and better tolerated than existing treatments.
The cost-effectiveness estimates are uncertain, particularly because of whether brigatinib’s treatment benefit continues after stopping treatment. The most plausible estimates for brigatinib compared with ceritinib are around the higher end of what NICE normally considers acceptable for an end-of-life treatment. But the population eligible for brigatinib is small and will decrease because crizotinib is no longer considered first-line treatment for ALK-positive NSCLC. Future treatments will be limited for those who have crizotinib. Taking these exceptional circumstances into
account, brigatinib is recommended for ALK-positive advanced NSCLC in adults who have had crizotinib.
Alunbrig was first made available in the EU in 2018. It is manufactured by Takeda.
European Medicines Agency website page for Alunbrig
Links available in full article
© NICE  Brigatinib for treating ALK-positive non-small-cell lung cancer after crizotinib [ID1328] Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
The information provided by NICE was accurate at the time this article was issued.
NICE draft guidance on Alunbrig for treating lung cancer
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