NICE is inviting feedback on the appraisal committee’s decision not to recommend abiraterone plus androgen deprivation therapy (ADT) for untreated high-risk hormone-sensitive metastatic prostate cancer.
While acknowledging the progression-free survival (PFS) and overall survival (OS) benefits seen in the LATITUDE and STAMPEDE trials, NICE’s appraisal committee decided against recommending abiraterone as “no plausible cost-effectiveness estimate for abiraterone plus ADT compared with docetaxel plus ADT can be established”.
“The company’s economic model does not reflect the number of treatments available to people with high-risk hormone-sensitive metastatic prostate cancer in NHS clinical practice, and does not give plausible estimates for modelled survival,” the committee determined.
“Also, clinical effectiveness and quality of life with abiraterone plus ADT compared with docetaxel plus ADT have not been fully explored using all available data relevant for this population,” it said.
In the absence of a “plausible” cost-effectiveness estimate, the committee concluded that there is no basis on which to recommend abiraterone plus ADT for untreated high-risk hormone-sensitive metastatic prostate cancer in adults.
Comments are now invited from consultees, commentators and the public, on whether all relevant evidence has been taken into account in making the decision and whether the clinical and cost effectiveness measures used are reasonable interpretations of the evidence.
The closing date for receipt of comments is 27 June 2018. The appraisal committee will consider the evidence and comments and will prepare a final appraisal document. Subject to any appeals, the final document may be used as the basis for NICE guidance on using abiraterone in the NHS in England.
Further details on the consultation process are available here.
