NHS England has struck a new deal on Keytruda (pembrolizumab), a new lung cancer immunotherapy. NHSE Chief Executive Simon Stevens announced that the checkpoint inhibitor drug will now be routinely prescribed on the NHS in England for patients with PD-L1 positive metastatic non-small-cell lung cancer (NSCLC), where it is expected to provide an additional 16 months of life.
The drug is notable for its £84,000 per patient full list price cost, which puts it over the £20 million budget impact threshold for new drugs. As a result negotiations were conducted between NHSE and Merck, Sharp & Dohme (MSD), resulting in an agreement to provide it at an undisclosed price under the new agreement.
Despite the landmark cost of the new drug, the new deal has been met with approval from NICE under the new CDF framework. Part of the rationale for this approval is that it will allow the generation of additional evidence to assess its effectiveness. NICE is expected to review its guidance in due course in light of the additional efficacy data from the estimated 1,800 patients who are expected to be eligible.
Keytruda has previously been licensed for NSCLC under the Early Access to Medicines Scheme (EAMS), but only for patients showing progression after other treatment. It is also licensed in a similar limited fashion for bladder cancer.