NICE Draft Guidance Advises Against Roche’s Perjeta

Draft guidance issued today by the regulatory body, NICE (National Institute for Health and Care Excellence), has confirmed that the NHS in England and Wales has been advised not to routinely provide Roche’s Perjeta (pertuzumab).

Perjeta was submitted as a treatment for a type of advanced breast cancer, but has been found not to represent value for money.

Perjeta has not been recommended as clinical data that was submitted to NICE’s independent appraisal committee was unable to calculate how long it might extend people’s lives, yet the drug cost more than current NHS treatments.

Roughly 50,000 women and 400 men are diagnosed with breast cancer in the UK every year, and about one in five tumours are HER2-positive, a type of breast cancer that can be treated with Roche’s Herceptin (trastuzumab).

NICE are currently evaluating whether the NHS should fund Perjeta, when used in combination with Herceptin and docetaxel, for HER2-positive tumours which have either recurred in the breast or spread to other parts of the body.

Perjeta’s recommended dose is an initial dose of 840mg followed by a dose of 420mg every three weeks, in combination with Herceptin and docetaxel.

However, the appraisal committee could not be sure of the benefits of the drug, as the “main clinical trial did not reflect current medical practice in the UK and, despite the research data suggesting the treatment could help delay the growth and spread of the disease, the evidence wasn’t robust enough to confirm for how long pertuzumab may actually extend people’s lives,” NICE’s chief executive, Sir Andrew Dillon, commented.

“The committee also noted that even the manufacturer estimated that the treatment would not be considered cost-effective for the NHS,” Dillon noted.

Roche informed the regulatory body that Perjeta would cost £2,395 per 420mg vial, excluding VAT, although costs may vary in different settings due to negotiated discounts.

The National Institute for Health and Care Excellence has now opened a consultation, which will run until the 28th August, to gather comments from interested parties to develop the guidance.


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