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NICE rejects Merck Serono’s Bavencio for urothelial cancer

Published on 10/05/21 at 11:11am
NICE building in London

The use of avelumab for maintenance treatment of locally advanced or metastatic urothelial cancer after platinum-based chemotherapy is not recommended by NICE following an announcement on May 6.

Clinical trial evidence shows that for people taking avelumab, also known as Bavencio and made by Merck Serono, it took longer for their cancer to get worse and they lived longer than if they had the best supportive care.

However, the potential cost-effectiveness estimates are significantly higher than what NICE considers to be an appropriate use of NHS resources. Also, as it was not clear how long people who have not had avelumab as cancer treatment would live for, the drug does not meet NICE’s criteria to be a life-extending treatment at the end of life.

Meindert Boysen, Deputy Chief Executive and Director of the Centre for Health Technology Evaluation at NICE, said: “We know there are currently few, if any treatments available for people with this form of urothelial cancer, and that avelumab is a promising drug that has the potential to address this unmet clinical need. 

“We are, therefore, committed to working with the company to help them address the issues identified by the committee that are highlighted in this draft guidance.” 

The list price for avelumab is £768.00 per 200mg/10ml concentrate for solution for infusion vials, but the company has a discount available to the NHS.

Additionally, because there are no planned studies that could address the uncertainties identified by the independent appraisal committee, it concluded that avelumab did not meet the criteria for inclusion in the Cancer Drugs Fund.

There are currently 750 patients with locally advanced or metastatic urothelial cancer whose disease has progressed after platinum-containing chemotherapy that are eligible for avelumab. Current available treatments include atezolizumab, docetaxel, paclitaxel, or best supportive care.

Patients with this type of cancer derive only minor benefit from chemotherapy. Avelumab is taken once every two weeks by intravenous infusion and allows the immune system to attack tumour cells.

The appraisal for avelumab will last until May 27, and the expected publication is August 25.

Lilly Subbotin

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