Nivolumab with ipilimumab for untreated unresectable malignant pleural mesothelioma

2.1 Nivolumab (Opdivo, Bristol Myers Squibb) plus ipilimumab (Yervoy, Bristol Myers Squibb) has a marketing authorisation 'for the first-line treatment of adult patients with unresectable malignant pleural mesothelioma'.

2.2 Nivolumab and ipilimumab are administered intravenously. The recommended dose is 360 mg over 30 minutes every 3 weeks for nivolumab and 1 mg per kilogram over 30 minutes every 6 weeks for ipilimumab. Treatment continues for up to 24 months or until the disease progresses. More details are available in the summary of product characteristics for nivolumab.

2.3 The list price of nivolumab is £2,633 per 240‑mg, 24‑ml vial (excluding VAT; BNF online, accessed June 2022). The list price of ipilimumab is £15,000 per 200‑mg, 40‑ml vial (excluding VAT; BNF online, accessed June 2022). The company has separate commercial arrangements for nivolumab and ipilimumab. These make nivolumab and ipilimumab available to the NHS with discounts. The sizes of the discounts are commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discounts.