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The National Institute for Health and Care Excellence (NICE) has recommended pembrolizumab in combination with chemotherapy (paclitaxel or nab-paclitaxel) which is said to benefit people with triple negative breast cancer. Clinical trial evidence shows that, compared with paclitaxel, pembrolizumab combination increases how long people have before their cancer gets worse and how long they live. NICE already recommends atezolizumab in combination with chemotherapy for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer. Atezolizumab combination is recommended by NICE for people with IC equal to or greater than 1%. "This means that some people who can't have atezolizumab combination could be eligible for pembrolizumab combination," said NICE. NICE's independent appraisal committee also agreed that the pembrolizumab combination meets the higher cost-effectiveness threshold for life-extending treatments for people with a short life expectancy. Given by injection every 3 weeks, pembrolizumab (also called Keytruda and made by Merck Sharp and Dohme) is a type of immunotherapy that specifically targets triple negative breast cancer. It works by blocking the activity of a protein known as PD-L1 which is produced in larger amounts on cancerous cells than normal cells. By blocking PD-L1 it helps the person's own immune cells to attack the cancer.

A new report has highlighted that the public places a higher value on medicines for severe medical conditions, such as terminal cancer, than the thresholds currently used by the National Institute for Health and Care Excellence (NICE). The study, conducted by the Office of Health Economics (OHE), found a misalignment between NICE's current 'severity modifier'-which determines whether a medicine is recommended for coverage on the National Health Service (NHS)-and the UK public's preference for prioritising health gains for more severe diseases. The research, commissioned and funded by the Association of the British Pharmaceutical Industry (ABPI), also indicated that the public is willing to pay more for medicines used to treat patients with severe disease. Titled 'Understanding Societal Preferences for Priority by Disease Severity in England and Wales,' the report suggested that NICE's current severity modifier may be limiting access to innovative treatments for NHS patients. The ABPI has called on the government and NICE to adopt a more flexible approach when assessing medicines for severe conditions.