NICE has published its final decision on the use of pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer. It has approved the treatment.
NICE has approved pertuzumab, with intravenous trastuzumab and chemotherapy, for the adjuvant treatment of human epidermal growth factor receptor 2 (HER2)-positive early stage breast cancer in adults. The treatment is recommended only in patients with lymph node-positive disease.
In previous draft guidance, NICE had concluded that uncertainty around the clinical effectiveness evidence made cost-effectiveness estimates for pertuzumab uncertain and the treatment could not be considered a good use of NHS resources. However, the company subsequently proposed a larger discount and submitted more conservative estimates of the duration of treatment benefit. The resulting cost-effectiveness estimate was below the NICE cost-effective threshold of £20,000 per QALY gained.
The new guidance is not intended to affect adjuvant treatment with pertuzumab that was started in the NHS before this guidance was published. People having treatment outside the recommendation stated in this guidance may continue without change to the funding arrangements in place before this guidance was published, until terminating treatment is considered appropriate.