5 September 2017

NICE Says Benefits of Breast Cancer Drug Fulvestrant too Uncertain to Make It Cost Effective

NICE has published draft guidance saying the evidence on using fulvestrant to treat a type of breast cancer does not prove it prolongs survival more than existing, less expensive treatments.

The draft guidance focuses on postmenopausal women who have oestrogen-receptor-positive, locally advanced breast cancer or breast cancer that has spread to other parts of the body, who have not already had treatment with hormonal therapy (aromatase inhibitors or tamoxifen).

The independent appraisal committee agreed that fulvestrant stalls the cancer’s growth by around 3 months compared to aromatase inhibitors, the drugs currently used to treat this type and stage of cancer. However, they found that the available evidence did not show that this leads to an increase in overall life expectancy.

Professor Carole Longson, director of the centre for health technology evaluation at NICE, said: “There is a need for more effective treatments for locally advanced or metastatic breast cancer to delay the need for chemotherapy and to extend survival. But NICE has to ensure that the NHS provides treatments that bring benefits which are value for money. As fulvestrant has not been shown to be cost-effective, we can’t justify diverting NHS funds from other areas of healthcare in order to fund its use.”

It is estimated that of the 32,000 postmenopausal women diagnosed with breast cancer each year in England, around 1200 would be eligible for treatment with fulvestrant.

Until NICE issues final guidance on fulvestrant NHS bodies should make decisions locally about its funding.

The draft guidance on fulvestrant (also called Faslodex) is open for public consultation until 25th September 2017.