Review decision – October 2020
Decision that the existing guidance remains unchanged
We would like to update you on the decision made regarding the review of the existing guidance on TA404; Degarelix for treating advanced hormone-dependent prostate cancer.
TA404 includes an optimised recommendation of degarelix for people with advanced hormone-dependent prostate cancer and spinal metastases. It concluded that degarelix was cost-effective in this subgroup of people with spinal metastases and that these patients were more likely to benefit because the risk of developing spinal compression was higher.
The cost-effectiveness results included a discounted price for degarelix. TA404 only recommends degarelix if it is available at the same discounted cost that was available in 2016. The company has confirmed that this discount is still in place. Furthermore, there have been no changes in price of the comparators.
In TA404, the committee preferred to assume no overall survival benefit for degarelix compared with LHRH agonists and no difference in the rate of fractures and cardiovascular events and this had a large impact on the cost-effectiveness results. Given the uncertainty in these areas, the committee’s preferred assumptions were conservative, and no new relevant clinical effectiveness evidence has been identified from the literature searches.
Overall, no new evidence has been identified that is likely to change the existing recommendations in TA404 therefore it is proposed that no update is required.
NICE’s Guidance Executive has decided to proceed with this proposal without consultation.
Consequently TA404 will not be updated at this time.
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