NICE's Tarceva Decision "Perverse", Says Roche

The UK National Institute for Health and Care Excellence’s (NICE) decision that relapsed non-small cell lung cancer patients should no longer have access to Roche’s cancer pill Tarceva (erlotinib) is a setback for lung cancer care in England and Wales, where “over 1,000 patients a year will be left without an active treatment option after their first-line therapy has failed”, a Roche press statement says.

NICE arrived at the decision because erlotinib does not meet its criteria for clinical and cost-effectiveness. However, patients in Scotland and the rest of Europe, Roche adds, will continue to benefit from the drug.

The decision will leave patients with access to only the chemotherapy, docetaxel, which many patients are too sick to tolerate, says the statement. “It seems perverse that this NICE guidance will limit the treatment options available to only docetaxel, given that the independent evidence review shows the total NHS treatment costs of docetaxel to be higher than those of erlotinib… The cost of managing treatment side effects is also greater with docetaxel, especially for life-threatening febrile neutropenia, which normally requires hospitalisation for antibiotic therapy.”

Roche points out that lung cancer treatment rates in the UK are already low, with less than 40% of patients receiving any kind of active treatment when their cancer relapses. The NICE decision, says the drug maker, “would reduce this even further”.

Clinicians, patients and the public have until 24 February to respond to the preliminary NICE decision.  NICE will publish its final decision in June.