NICE backs Herceptin for limited population

The U.K's NICE issued a final appraisal determination recommending Herceptin trastuzumab in a more limited population than its approved indication, for which NICE rebuffed the Roche (SIX:ROG; OTCQX:RHHBY) drug in July. The committee now recommends Herceptin in combination with cisplatin and capecitabine or 5-fluorouracil to treat HER2-positive, metastatic adenocarcinoma of the stomach or gastro-esophageal junction in patients who have not received prior treatment and whose tumors express high levels of HER2, as defined by a positive immunohistochemistry score of 3 (IHC3 positive). NICE said gastric cancer affects 8,200 patients in the U.K. each year -- of whom about 500 would be eligible to receive Herceptin under NICE's recommendation.

The FAD reverses a July preliminary appraisal recommending against Herceptin in the indication, irrespective of IHC score. NICE said Roche submitted a new analysis on a subgroup of patients with the highest levels of HER2. The committee concluded that Herceptin for this group of patients met the criteria for a life-extending, end-of-life treatment, and therefore was cost-effective. NICE said the most plausible incremental cost-effectiveness ratio (ICER) estimates for the subgroup were in the range of L45,000-L50,000 ($71,000-$79,000) per quality-adjusted life year (QALY) gained. ICER estimates for the full approved population were in the range of L63,100-L71,500 ($100,000-$113,000) per QALY gained. ...