The National Institute for Health and Clinical Excellence has issued final guidance recommending the use of Merck KGaA’s cancer drug Erbitux on the National Health Service for patients with colorectal cancer.

Specifically, the cost regulator has given the green light for the use of the drug in combination with a chemotherapy regimen known as FOLFOX – 5-fluorouracil, folinic acid and oxaliplatin - as a first-line weapon against the disease under the following conditions: the primary tumour has been resected or can be operated on; disease spread is confined to the liver and is inoperable; and the patient is well enough to undergo surgery to remove the primary tumour or the diseased part of the liver if this is possible following treatment.

In addition, the Institute has given the all clear for the drug’s use in combination with 5-FU, folinic acid and irinotecan (known as FOLFIRI) as a first-line defence when the above criteria are met, and the patient is unable to take oxaliplatin. NICE has also stipulated that patients in either subset should not be treated with the drug for more than 16 weeks.

Approval of the drug for use on the NHS was based upon a cost analysis that concluded it would be a cost-effective use of resources, taking into account clinical evidence showing its ability to significantly shrink tumours as well as a risk-sharing scheme proposed by Merck, under which it offers a 16% rebate to the health service on the cost of treatment per patient.