Roche gets a NICE knockback for melanoma drug, Cotellic
The National Institute for Health and Care Excellence (NICE) has announced that that it has not recommended Roche’s melanoma drug, Cotellic (cobimetinib), in draft guidance.
The MEK 1 and MEK2 inhibitor is indicated in combination with Zelboraf (vemurafenib) for the treatment of unresectable or metastatic melanoma in adults with a BRAF V600 mutation. Roche’s stated price for a one month regimen of the drug is £4,275.67.
The evidence provided showed that the combination treatment extends survival by an average (median) of 4.9 months compared with Zelboraf, alone. In its analysis, NICE determined that “the incremental cost effectiveness ratios were over £100,000 per QALY (quality adjusted life year) gained.” This figure substantially surpasses the rate at which NICE would usually approve new treatments, of around £20,000 per QALY.
In terms of clinical need, NICE points to numerous other treatment options available, or becoming available, such as immunotherapy agents Opdivo (nivolumab) and Keytruda (pembrolizumab), and targeted BRAF inhibitors such as Tafinlar (dabrafenib).
Despite additional factors such as an agreed discount on both drugs with the Department of Health, the drug was not recommended. This stage of consultation will remain open until July 7.
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