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New HTA Decisions in England
August 2019
Drug name
VIZIMPRO® (dacomitinib)
Company
Pfizer
Decision date
05/07/2019
Therapeutic area
Cancer
Therapeutic sub area
Lung cancer
Decision
Recommended
Indication
As an option for untreated locally advanced or metastatic epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) in adults.
Decision Detail
It is recommended only if the company provides it according to the commercial arrangement.
Summary
ARCHER 1050, a multicentre, open-label, phase III randomised controlled trial, provided the main clinical evidence. The committee concluded that, overall, dacomitinib is associated with improved progression-free and overall survival compared with gefitinib. The committee agreed that dacomitinib had a higher incidence of adverse events and needed more dose reductions than gefitinib. It concluded that how this affected health-related quality of life and resource costs for managing adverse events should be fully captured in the cost-effectiveness analysis. An indirect comparison suggests there is no statistically significant difference between dacomitinib and afatinib in terms of extending progression-free and overall survival. There is some uncertainty about the assumptions used in the cost-effectiveness modelling. The committee was aware that the differences among the company's and ERG's base cases and the alternative scenario ICERs were driven by the different assumptions about overall survival for all treatments. The committee concluded that the most plausible ICER for dacomitinib was within the range normally considered to be a cost-effective use of NHS resources (dacomitinib and the comparators have confidential commercial arrangements so the exact ICERs cannot be reported here).