NICE gives final draft guidance on two key cancer drugs

NICE has announced it has published its final draft guidance for two cancer treatments, covering Bayer’s Stivarga (regorafenib) in the treatment of gastrointestinal stromal tumours (GIST), and Roche’s Erivedge (vismodegib) in the treatment of advanced basal cell carcinoma (BCC) that cannot be treated with surgery or radiotherapy.

Reorafenib is currently available on the Cancer Drugs Fund (CDF), but NICE’s latest recommendation advises that it should now be taken off the fund and made routinely available to select patients on the NHS as a therapy to treat GIST in situations where it has metastasized, cannot be addressed with surgery, or where no alternative treatments are appropriate.

The decision was based on data suggesting that the drug has the ability to extend life by over nine months compared to ‘best supportive care’, which manages symptoms but does not actively treat the disease. The price to be paid by the NHS for treatment has been negotiated as part of a confidential patient access scheme, and will be lower than the £3,744 per three-week treatment cycle noted on the drug’s list price.

Secondly, the appraisal committee at NICE has deemed that clinical benefits provided by vismodegib were unclear. This, combined with its high cost, has led NICE to the decision to recommend the removal the drug from the CDF due to its ineligibility, with final publication expected on 22 November. In this situation, treatments removed from the fund will be heralded by two month’s notice.

Both pieces of final guidance have been given to the relevant consultees, who are now free to appeal the decisions within.