The National Institute for Health and Care Excellence has decided that use of Merck's head and neck cancer drug Erbitux is not cost-effective for the NHS in England and Wales.

NICE originally published guidance in 2009 concluding that Erbitux (cetuximab) does not offer value for money as a treatment for recurrent and/or metastatic squamous cell cancer of the head and neck, but the drug later became available to patients on the NHS through the CDF.

The Institute is now assessing the drug under its programme to reappraise medicines currently funded for NHS use via the CDF. As part of this, Merck has presented further evidence not included in their original submission and narrowed the target treatment population to those with mouth cancer only, which affects around 2,300 people in England and Wales.

However, despite this narrowed scope and newly-discounted price to the NHS, the committee remained concerned about the considerable uncertainty in the evidence and thus could not recommend Erbitux as cost effective.

"This decision not to recommend cetuximab as an option for treating mouth cancer will be disappointing for some patients. However we need to make sure the NHS makes the most of its resources by only funding treatments that are both clinically effective and represent good value for money," said Professor Carole Longson, director of the health technology evaluation centre at NICE.

Until final guidance is issued to the NHS, Erbitux will remain available to patients in the old CDF.