The National Institute for Health and Care Excellence is sticking with its stance that Novartis’ Certican is too expensive for National Health Service use as a treatment for organ rejection in liver transplant patients.

The cost watchdog has published final draft guidance echoing a preliminary decision that, while may offer some benefit in preserving kidney function, the immunosuppressant costs too much compared to current treatments already available on the NHS.

NICE’s Expert Review Committee concluded that incremental cost effectiveness ratios for Certican (everolimus) in combination with reduced-dose tacrolimus would not be less than £110,000 per QALY gained against any relevant comparator, and thus far outside the realm of what is normally considered value for money.

Final guidance is expected next month, but in the meantime organisations can make decisions locally whether to fund treatment with the drug.