Glaxo plans to renew talks with UK health officials in hopes of reversing a decision that the National Health Service will not adopt its Tykerb cancer medicine over concerns that its cost outweighs its benefits, The Financial Times reports.

The National Institute for Health and Clinical Excellence, or NICE, which advises the NHS, recently ruled against the use of Tykerb, effectively killing the drug’s use in the UK. The decision was the latest in a series of rejections of high-priced cancer meds, and a stand-off in which NICE recommended that other meds not be used, the FT reminds us.

Glaxo has been attempting to price Tykerb, which is called Tyverb in the UK, in an innovative way by proposing a cap on the total cost to the NHS, no matter how many patients use it. The idea is to set a fixed price to cover the cost for several thousand patients. Glaxo estimates this would benefit about 70 per cent of those in the UK who fail other cancer treatments including Herceptin.

The move comes as Glaxo considers the unusual step of giving government healthcare systems a say in deciding which drugs advance in its research pipeline, which it hopes will eventually prompt government officials to agree to pay for its meds (back story).

Glaxo would charge the same minimum price if fewer patients were recruited, but if the NHS could identify and offer the drug to a higher number judged likely to benefit, Glaxo would not charge for additional orders, according to the FT.

NICE has approved several innovative approaches by other companies, including one with Janssen Cilag for Velcade for multiple myeloma, under which the NHS pays only for those drugs used on patients showing a clear positive response, the FT writes.

Tyverb is more complex, because unlike Velcade there is no clear “biomarker” or blood test that quickly and easily demonstrates improvement. Glaxo talks with the Department of Health have failed so far in part because of difficulties in co-ordinating use of Tykerb across the NHS, and the switch from those who fail on Herceptin to Tykerb as an alternative.

Some critics argue pharma should be willing to offer meds at a lower initial price, with the prospect that as the drugs become more widely used for different illnesses they would benefit from greater overall sales to offset lower margins. But drugmakers, the FT points out, are reluctant to cut prices in the UK for fear it would spark copycat pressures in other markets and limit their commercial flexibility.