NICE Recommends Ferring Drug For Advanced Prostate Cancer

The National Institute for Health and Care Excellence (NICE) has issued its Final Appraisal Determination (FAD) for Firmagon (degarelix). The Institute has recommended the drug for advanced prostate cancer, but only in special cases.

NICE recommended Firmagon as an option for treating advanced hormone-dependent prostate cancer, but only in adults with spinal metastases who present signs or symptoms of spinal cord compression. Ferring Pharmaceuticals expressed disappointment in the restrictive recommended use.

Dr. Patrick Davey, consultant cardiologist at the  Northampton General Hospital, said, “Given the high UK prevalence of prostate cancer and also cardiovascular disease (CVD), it means that approximately one in three men with prostate cancer would have experienced a cardiovascular event. Patients with pre-existing CVD are most at risk and the evidence shows that Firmagon has a higher chance of reducing that. It is unfortunate that NICE has chosen not to recommend it in a wider patient group. I should, and need, to be able to offer my patients the most appropriate therapy to reduce the risk of CV events as well as, of course, death.”

The company said that its drug has demonstrated several advantages over standard hormonal therapies. These include more rapid reduction in prostate specific antigen (PSA), better control of Serum Alkaline Phosphatase (S-ALP), and significant reduction in PSA progression. Ferring said these factors point towards improved disease control and associated reduced risk of cardiovascular disease.

Clinical studies of Firmagon also demonstrated fewer musculoskeletal events as well as lower incidence of renal or urinary tract events when compared to patients treated with LHRH agonists 3. Those treated with Firmagon showed significantly longer progression-free survival 4 and a faster response 5 compared to agonist treatment.

Steven Howson, General Manager of Ferring UK, said, “Whilst we are pleased that NICE has recommended Firmagon for certain prostate cancer patients, it is obviously disappointing for the English and Welsh prostate cancer community and their physicians that full access has not been granted in all the patient groups where proven efficacy and safety benefits have been demonstrated over existing therapies. We now need to consider what our response to this will be.”