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Cabazitaxel for the Second-Line Treatment of Metastatic Hormone-Refractory Prostate Cancer: A NICE Single Technology Appraisal

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  • Ben Kearns
  • Myfanwy Lloyd Jones
  • Matt Stevenson
  • Chris Littlewood

Abstract

The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of cabazitaxel (Jevtana ® , sanofi-aventis, UK) to submit evidence of its clinical and cost effectiveness for the second-line treatment of metastatic hormone-refractory prostate cancer (mHRPC). The School of Health and Related Research Technology Appraisal Group (ScHARR-TAG) at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology based upon the manufacturer’s submission to NICE. Clinical evidence was derived from a multinational randomized open-label phase III trial of cabazitaxel plus prednisone or prednisolone in men with mHRPC that had progressed during or following treatment with docetaxel. The comparator was mitoxantrone plus prednisone or prednisolone. Use of cabazitaxel was associated with a statistically significant improvement in overall survival, median progression-free survival and time to tumour progression. However, it was also associated with an increased incidence of adverse events such as neutropenia. Utility data were based on interim results from the early access programme for cabazitaxel. Data were only available for a small number of patients with stable disease, resulting in great uncertainty as to the effect of cabazitaxel on quality of life. For their economic evaluation, the manufacturer estimated that the use of cabazitaxel was associated with an incremental cost of £74,908 per QALY gained. However, the ERG disagreed with the manufacturer over two key methodological points. The first concerned modelling and extrapolating survival; the second point was concerned with the choice of patient population. The ERG altered the manufacturer’s evaluation to take into account these two points of disagreement. The resulting cost per QALY gained was £82,950. The NICE Appraisal Committee believed the analysis presented by the ERG to be more plausible, and likely to be an underestimate of the cost per QALY. They concluded that whilst the clinical effectiveness of cabazitaxel had been proven, it was not likely to represent a cost-effective use of NHS resources and so its use could not be recommended. Copyright Crown Copyright 2013

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  • Ben Kearns & Myfanwy Lloyd Jones & Matt Stevenson & Chris Littlewood, 2013. "Cabazitaxel for the Second-Line Treatment of Metastatic Hormone-Refractory Prostate Cancer: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(6), pages 479-488, June.
    • Handle: RePEc:spr:pharme:v:31:y:2013:i:6:p:479-488
    DOI: 10.1007/s40273-013-0050-9
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    References listed on IDEAS

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    1. Jonathan Tosh & Rachel Archer & Sarah Davis & Matt Stevenson & John Stevens, 2013. "Golimumab for the Treatment of Rheumatoid Arthritis After the Failure of Previous Disease-Modifying Antirheumatic Drugs: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(8), pages 653-661, August.
    2. Huiqin Yang & Dawn Craig & David Epstein & Laura Bojke & Kate Light & Ian Bruce & Mark Sculpher & Nerys Woolacott, 2012. "Golimumab for the Treatment of Psoriatic Arthritis," PharmacoEconomics, Springer, vol. 30(4), pages 257-270, April.
    3. Rachid Rafia & Emma Simpson & Matt Stevenson & Diana Papaioannou, 2013. "Trabectedin for the Treatment of Advanced Metastatic Soft Tissue Sarcoma: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(6), pages 471-478, June.
    4. E. Simpson & P. Fitzgerald & P. Evans & P. Tappenden & N. Kalita & J. Reckless & A. Bakhai, 2013. "Bivalirudin for the Treatment of ST-Segment Elevation Myocardial Infarction: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(4), pages 269-275, April.
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    1. Rachid Rafia & Emma Simpson & Matt Stevenson & Diana Papaioannou, 2013. "Trabectedin for the Treatment of Advanced Metastatic Soft Tissue Sarcoma: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(6), pages 471-478, June.
    2. Angelis, A. & Linch, M. & Montibeller, G. & Molina-Lopez, T. & Zawada, A. & Orzel, K. & Arickx, F. & Espin, J. & Kanavos, P., 2020. "Multiple Criteria Decision Analysis for HTA across four EU Member States: Piloting the Advance Value Framework," Social Science & Medicine, Elsevier, vol. 246(C).
    3. Nigel Armstrong & Manuela Joore & Thea Asselt & Kate Misso & Nathan Manning & Florian Tomini & Jos Kleijnen & Rob Riemsma, 2013. "Golimumab for the Treatment of Ankylosing Spondylitis: A NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 31(5), pages 415-425, May.
    4. Janette Greenhalgh & Adrian Bagust & Angela Boland & Michaela Blundell & James Oyee & Sophie Beale & Yenal Dundar & Juliet Hockenhull & Chris Proudlove & Patrick Chu, 2013. "Rituximab for the First-Line Maintenance Treatment of Follicular Non-Hodgkin’s Lymphoma," PharmacoEconomics, Springer, vol. 31(5), pages 403-413, May.

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