NICE rejection of Erbitux in head and neck cancer is final
This article was originally published in Scrip
Using Merck Serono's (Merck KGaA) Erbitux (cetuximab), in combination with platinum-based chemotherapy, to treat patients in England and Wales with recurrent and/or metastatic squamous cell cancer of the head and neck would not be a cost-effective use of UK national health service resources, an assessment agency has found.
The National Institute for health and Clinical Excellence (NICE), which evaluates health technologies for the NHS, has published binding guidance that reiterates the conclusions of an earlier draft (scripnews.com, April 28th, 2009).
The institute published guidance last year, all but ruling out cetuximab in a similar indication, locally advanced squamous cell cancer of the head and neck. It said cetuximab could be used in a subset of patients with Karnofsky performance status scores of 90% or more and for whom all forms of platinum-based chemotherapy were considered inappropriate, but there are few – if any – patients who meet these criteria.
Cetuximab was also rejected in colorectal cancer indications.
In metastatic head and neck cancer, the NICE appraisal committee estimated that the cost of an additional quality-adjusted life year resulting from treatment with cetuximab plus platinum-based chemotherapy compared with platinum-based chemotherapy alone would be £121,367, and predicted an overall gain in survival of just over two months.
"This would mean the NHS making significant funds available for a very expensive treatment which may or may not benefit individual patients. Those funds would not then be available for treating other conditions with greater and more certain benefits for other patients," NICE said.