£244,000 per QALY for a sub-group, £61,400 for a further sub-group and doesn’t meet end-of-life guidance.
That’s the tweet over with. Here’s a bit more detail from NICE:
The Committee noted that, for the sub-group of patients who had not had prior chemotherapy and using a discounted price for abiraterone, the cost per QALY (quality-adjusted life year) was at least £512,000 (company’s analyses) or at least £244,000 (Evidence Review Group’s analyses) for sipuleucel-T compared with abiraterone. When abiraterone was not included in the Evidence Review Group’s analysis, the cost per QALY for sipuleucel‑T compared with best supportive care was £112,000.
For the sub-group with baseline prostate-specific antigen levels of 22.1 ng/ml or below, the company’s original analyses resulted in a cost per QALY of £48,700 for sipuleucel‑T compared with best supportive care. The company’s revised analyses resulted in a higher cost per QALY. The Evidence Review Group’s exploratory analysis resulted in a cost per QALY of £61,400 for sipuleucel-T compared with best supportive care.
The Committee considered that the mean life expectancy for people with metastatic hormone-relapsed prostate cancer for which chemotherapy is not yet indicated was unlikely to be less than 24 months, so sipuleucel-T at this stage in the treatment pathway did not meet the first end-of-life criterion for short life expectancy.
ScHARR-TAG were the ERG for this, with the team from HEDS being Emma Simpson, Sarah Davis, Praveen Thokala, Penny Breeze and Ruth Wong. The full report is available here.