Houten, Rachel 
ORCID: 0000-0002-4315-7732, Fleeman, Nigel ORCID: 0000-0002-4637-9779, Mahon, James, Chaplin, Marty ORCID: 0000-0002-7097-8704, Edwards, Katherine, Beale, Sophie ORCID: 0000-0003-0164-103X, Boland, Angela ORCID: 0000-0002-5435-8644, Dundar, Yenal, Marsden, Ashley, Malik, Zafar et al (show 1 more authors)
(2023)
Trastuzumab Deruxtecan for Treating HER2-Positive Unresectable or Metastatic Breast Cancer After Two or More Anti-HER2 Therapies: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.
PHARMACOECONOMICS-OPEN, 7 (3).
pp. 345-358.
ISSN 2509-4262, 2509-4254
Abstract
The National Institute for Health and Care Excellence (NICE) provides guidance to improve health and social care in England and Wales. NICE invited Daiichi Sankyo to submit evidence for the use of trastuzumab deruxtecan (T-DXd) for treating human epidermal growth factor 2 (HER2)-positive unresectable or metastatic breast cancer (UBC/MBC) after two or more anti-HER2 therapies, in accordance with NICE's Single Technology Appraisal process. The Liverpool Reviews and Implementation Group, part of the University of Liverpool, was commissioned to act as the Evidence Review Group (ERG). This article summarises the ERG's review of the evidence submitted by the company and provides an overview of the NICE Appraisal Committee's (AC's) final decision made in May 2021. Results from the company's base-case fully incremental analysis showed that, compared with T-DXd, eribulin and vinorelbine were dominated and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) gained versus capecitabine was £47,230. The ERG scenario analyses generated a range of ICERs, with the highest being a scenario relating to a comparison of T-DXd versus capecitabine (£78,142 per QALY gained). The ERG considered that due to a lack of appropriate clinical effectiveness evidence, the relative effectiveness of T-DXd versus any comparator treatment could not be determined with any degree of certainty. The NICE AC agreed that the modelling of overall survival was highly uncertain and concluded that treatment with T-DXd could not be recommended for routine use within the National Health Service (NHS). T-DXd was, however, recommended for use within the Cancer Drugs Fund, provided Managed Access Agreement conditions were followed.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 32 Biomedical and Clinical Sciences, 3211 Oncology and Carcinogenesis, Health Services, Women's Health, Breast Cancer, Cancer, Cost Effectiveness Research, Clinical Research, Clinical Trials and Supportive Activities, 6.1 Pharmaceuticals, Cancer, 3 Good Health and Well Being |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 02 Jun 2023 09:32 |
| Last Modified: | 25 Sep 2025 16:50 |
| DOI: | 10.1007/s41669-023-00405-2 |
| Open Access URL: | https://doi.org/10.1007/s41669-023-00405-2 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3170794 |
Altmetric
Altmetric