NICE has today published final guidance for the NHS approving the use of a new drug to treat kidney cancer.

Pazopanib (Votrient, GlaxoSmithKline), is recommended as a first-line treatment option for people with advanced renal cell carcinoma who have not received prior cytokine therapy and have an Eastern Cooperative Oncology Group (ECOG)[1]performance status of 0 or 1. As agreed under the patient access scheme the manufacturer will also provide pazopanib with a 12.5% discount on the list price and a possible future rebate linked to the outcome of the head-to-head trial, known as the COMPARZ trial, comparing pazopanib and sunitinib, details of which will be confirmed when the COMPARZ trial data are made available.

Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "Pazopanib will offer patients an additional option to sunitinib, which is also recommended by NICE. Although a direct comparison of pazopanib and sunitinib is not yet available, a trial comparing the two drugs is currently underway and the current patient access scheme proposed by the manufacturer makes pazopanib a cost-effective option for the NHS."

Renal cell carcinoma is a kidney cancer (tumour) that starts in cells lining the small tubes that help to make urine. In advanced disease, the tumour has spread inside the kidney, but may or may not have spread to nearby lymph glands. In metastatic renal cell carcinoma, the tumour has spread beyond the lymph glands to other parts of the body. In March 2009, NICE recommended sunitinib for people with advanced renal cell carcinoma[2].

Ends

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Notes to Editors

About the appraisal

1. The guidance will be available from 23 February: www.nice.org.uk/guidance/TA215

2. The manufacturer of pazopanib agreed a two-part patient access scheme with the Department of Health. Part A of the patient access scheme provides a 12.5% discount from the list price. Therefore the daily acquisition cost of pazopanib is £65.39. Part B of the patient access scheme, the details of which are 'commercial-in-confidence' and cannot be reported, offers a future rebate linked to the head-to-head COMPARZ trial.

3. The end of life considerations did apply to this appraisal in relation to pazopanib compared with interferon-α.

4. The trial evidence presented indicates that pazopanib, can delay progression of the cancer by approximately eight months compared with placebo. This does not address the comparison with active treatments used for this patient group. The Committee appreciated that a head to head trial versus sunitinib is ongoing and considered it appropriate at this time to review the indirect evidence provided by the company. On that basis the Committee considered it acceptable to conclude that pazopanib is likely to be a cost effective use of NHS resources.

About NICE

5. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

6. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

7. NICE produces standards for patient care:

• quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

8. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.