UK cost watchdog the National Institute for Health and Clinical Excellence is now endorsing the use of Roche’s Herceptin to treat a certain subgroup of gastric cancer patients, following an outright rejection earlier this year.

In its latest draft guidance published this morning, the Institute said it would allow the use of Herceptin (trastuzumab), in combination with cisplatin and capecitabine or 5-fluorouracil, as a treatment for metastatic gastric cancer on the National Health Service.

However, it said treatment should be restricted to patients who have high levels of human epidermal growth factor receptor 2, as defined by a positive immunohistochemistry score of 3, and have not received prior treatment for metastatic disease.

The decision marks a turnaround from an earlier ruling by the cost watchdog rejecting the drug for all patients within the licensed population, after a new analysis provided by Roche during the consultation persuaded the Institute that Herceptin is a cost-effective use of NHS resources for the IHC3-positive group of patients.

NICE’s cost-modelling based on the new data from Roche showed that the most plausible estimates of cost effectiveness for the IHC3 positive subgroup were between £45,000 and £50,000, while those for an unrestricted population fell between £63,100 and £71,500 per QALY gained.

In addition, the Appraisal Committee agreed that Herceptin fitted the criteria for appraising life-extending, end-of-life treatments, enabling it to recommend the drug’s restricted use on the NHS.