Trastuzumab for the Treatment of HER2Positive Met

Authors: Eldon Spackman Stephen Rice Gill Norman DongChurl Suh Alison Eastwood Stephen Palmer

Publish Date: 2013/02/01

Volume: 31, Issue: 3, Pages: 185-194

PDF Link

Abstract

The National Institute for Health and Clinical Excellence NICE invited the manufacturer of trastuzumab Roche Pharmaceuticals to submit evidence for the clinical and cost effectiveness of this drug for the treatment of advanced gastric cancer aGC as part of the Institute’s single technology appraisal STA process The Centre for Reviews and Dissemination CRD and the Centre for Health Economics CHE Technology Appraisal Group at the University of York was commissioned to act as the evidence review group ERG This article provides a description of the company submission the ERG report and NICE’s subsequent decisions In the initial appraisal by NICE trastuzumab was rejected for use in the licensed population Given this result the manufacturer submitted additional evidence In the final appraisal decision trastuzumab was approved in accordance with supplementary guidance issued by NICE on appraising lifeextending endoflife treatments for patients whose human epidermal growth factor receptor 2 HER2 status was defined by an immunohistochemistry 3 positive IHC3+ result This appraisal highlights the need to fully assess the impact of different approaches to diagnostic testing on the cost effectiveness of targeted treatments In this appraisal it was found that the diagnostic strategy influenced the effectiveness and cost of trastuzumab In the future different diagnostic strategies should be compared in the incremental costeffectiveness analysisThe authors would like to acknowledge clinical advisors Daniel Swinson and Matthew Seymour They would also like to acknowledge Ralph Crott Anthony DansoAppiah and Gerry Richardson for early comments on the project and Lisa Stirk for her literature searching support This project was funded by the National Institute for Health Research NIHR Health Technology Assessment Programme project number 08/219/01 and has been published in full in Health Technology Assessment 36 See the Health Technology Assessment Programme website http//wwwhtaacuk for further project information This summary of the ERG report was compiled after the appraisal committee’s review and has not been externally peer reviewed by PharmacoEconomics The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Department of HealthEldon Spackman and Stephen Rice wrote the economics section Gill Norman wrote the clinical effectiveness sections of the report DongChurl Suh reviewed and commented on the report Stephen Palmer and Alison Eastwood managed the costeffectiveness and clinical effectiveness parts of the project and reviewed and commented on the report Eldon Spackman acts as guarantor for the overall content

Keywords: