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New HTA Decisions in England
December 2020
Drug name
TECENTRIQ® (atezolizumab)
Company
Roche
Decision date
12/11/2020
Therapeutic area
Cancer
Therapeutic sub area
Liver cancers
Decision
Recommended with restrictions
Indication
Atezolizumab plus bevacizumab is recommended as an option for treating advanced or unresectable hepatocellular carcinoma (HCC) in adults who have not had previous systemic treatment.
Decision Detail
It is recommended only if: • they have Child‑Pugh grade A liver impairment and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 and; • the company provides it according to the commercial arrangement (there are simple discount patient access schemes for atezolizumab and bevacizumab).
Summary
Based on the IMbrave150 trial, clinical evidence shows that people with Child-Pugh grade A liver impairment and an ECOG performance status of 0 or 1 who have atezolizumab plus bevacizumab had statistically significantly longer progression-free survival and overall survival compared with sorafenib. Results of an indirect comparison suggest that atezolizumab plus bevacizumab is more effective than lenvatinib, but this is uncertain because there is no direct evidence comparing them. The committee concluded that the most plausible ICER was highly likely to be less than £50,000 per QALY gained for atezolizumab plus bevacizumab compared with sorafenib and with lenvatinib. Despite the uncertainty in the indirect comparison, the most likely cost-effectiveness estimates for atezolizumab plus bevacizumab compared with sorafenib and with lenvatinib are within what NICE considers an acceptable use of NHS resources, therefore atezolizumab plus bevacizumab is recommended.