In the draft guidance, NICE considers rituximab (MabThera, Roche products) in combination with a wide range of chemotherapy treatments for people with symptomatic stage III and IV follicular lymphoma to be both clinically and cost-effective.
HEDS provided the independent report for the Committee and showed that the ICERs for the addition of rituximab to CVP, CHOP and MCP are £7,720, £10,834 and £9,316 per QALY gained respectively when it was assumed that first line rituximab maintenance was not used. These were only slightly higher than the manufacturer’s estimates of £5,611, £5,758 and £4,861 respectively.
However, when it was assumed that patients responding to first-line induction with R-chemotherapy receive first-line maintenance rituximab for up to 2 years, the ICERs increase to £14,959, £21,687 and £20,493 per QALY gained respectively.
This appraisal was one of the few multiple technology appraisals (MTAs) still commissioned by NICE and was undertaken by Diana Papaioannou, Rachid Rafia, John Rathbone, Matt Stevenson, and Helen Buckley Woods.