The preliminary recommendations from the National Institute for Health and Clinical Excellence (NICE), the body that provides guidance to the UK National Health Service, looked at the aromatase inhibitors (AIs) class of drugs, which includes Novartis' Femara (letrozole), AstraZeneca's Arimidex (anastrozole), and pfizer's Aromasin (exemestane).
AIs have been recommended for the adjuvant treatment of early oestrogenreceptor-positive invasive breast cancer in post-menopausal women, in accordance with their licensed indications.
The recommendation includes an independent cost-effectiveness analysis conducted by NICE, which showed that for primary adjuvant treatment for five years, the costs per quality-adjusted life-year (QALY) gained were GBP21,580 with Femara (letrozole) and GBP31,965 with anastrozole when compared with tamoxifen therapy for the same time period. Based on this analysis, both treatments were considered to be cost effective by NICE, in comparison with tamoxifen.
Novartis Oncology has welcomed this positive initial guidance, which recommends Femara for the treatment of women directly following surgery, as well as for those women who have completed five years of standard adjuvant tamoxifen use (extended adjuvant use). Femara is the only AI to have a license in the extended adjuvant setting.
Following comments from stakeholders and further review from the committee, the final guidance on the use of AIs in early breast cancer is due to be published in November; at which point the NICE guidance would come into effect.