Dermatologist inspecting a patient's skin

Routine NHS use of skin cancer drug recommended

NICE has recommended the routine NHS use of a new skin cancer drug, as an option after surgery for some patients with melanoma.

Final draft guidance on the drug (called nivolumab) was issued by NICE on February 12, 2021 with an appeal period now open until February 26, 2021.

Nivolumab was available for the past two years within the Cancer Drugs Fund, recommended for use as an option for the adjuvant treatment of completely resected melanoma in adults with lymph node involvement or metastatic disease.

This allowed for patients to access the drug while data on its effectiveness was being collected, in order to address significant clinical uncertainty.

Under these terms, its use was permitted in set circumstances but more data was required to be gathered before it could be considered for routine commissioning. This meant until recently, NICE had been unable to recommend the use of nivolumab in draft guidance.

Even now it has the data required to make the recommendation, NICE made clear reference to the fact the data from the Cancer Drugs Fund and key clinical trial were still relatively immature and so it was uncertain what impact nivolumab would have on life of time people lived for or by how much it increased overall survival rates.

Following consultation, the committee was persuaded that some of its preferred assumptions for estimating long-term survival of people who had been treated with nivolumab had been too conservative.

New analyses presented by the drug’s manufacturer showed that the most likely estimates of cost-effectiveness were within the range NICE considers a cost-effective use of NHS resources.

In response, the committee at NICE has now recommended the routine use of nivolumab as an option after surgery for some people with melanoma, subject to the drug manufacturer providing it according to the commercial arrangement agreed with the NHS.

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