Roche’s Erivedge will indeed no longer be funded on the National Health Service as a treatment for skin cancer after cost regulators issued final guidance ruling that it is not cost effective.
Erivedge (vismodegib) was made available to patients with advanced basal cell carcinoma (BCC) unable to receive surgery or radiotherapy via the old CDF in 2013.
But following a reappraisal, NICE’s committee concluded that its clinical benefit was unclear.
It noted clinical data on overall survival in people with locally advanced basal cell carcinoma are limited, and only a small number of patients with metastatic BCC were included in trials.
Also, it was pointed out that no trials directly compare Erivedge with best supportive care, and that while results of an analysis comparing treatments suggests that the drug may provide some benefit, the methods used “are not good enough for decision-making”.
The most likely estimate of cost effectiveness for Erivedge compared with best supportive care was calculated to be much higher than £30,000 per quality-adjusted life year (QALY) gained, NICE said.
The Institute did note that its economic assessment may not have fully captured the quality-of-life benefits of the drug, but stressed that even taking this into account the cost effectiveness estimate would not have been lowered “to an acceptable level”.
Erivedge will now be removed from the Cancer Drugs Fund within two months. Patients currently receiving treatment with the drug – which Roche estimates at around 150 in number – will continue to do so.
Advanced BCC is thought to occur in up to 10 percent of all BCCs, with locally advanced BCC that is inappropriate for surgery or radiotherapy occurring in up to 1 percent of cases.