Cabozantinib for treating medullary thyroid cancer

2.1 Cabozantinib (Cometriq) is indicated for use in 'adults with progressive, unresectable locally advanced or metastatic medullary thyroid cancer. For patients in whom rearranged during transfection mutation status is not known or is negative, a possible lower benefit should be taken into account before individual treatment decision'.

2.2 140 mg taken orally once daily until patient is no longer clinically benefitting from therapy or until unacceptable toxicity occurs. Dose reductions of 100 mg or 60 mg are available if needed.

2.3 £4,800 per 84×20-mg pack, 28×20-mg + 28×80-mg pack and 84×20-mg + 28×80-mg pack (excluding VAT; British national formulary July 2017). The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of cabozantinib with the discount applied at the point of purchase or invoice. The level of the discount is commercial in confidence. The Department of Health considered that this patient access scheme would not constitute an excessive administrative burden on the NHS.