2 The technology
Marketing authorisation indication
2.1 Avelumab (Bavencio, Merck) is indicated as monotherapy for 'the treatment of adult patients with metastatic Merkel cell carcinoma'.
Dosage in the marketing authorisation
2.2 The dosage given in the JAVELIN trial was 10 mg/kg every 2 weeks by intravenous infusion over 60 minutes. Avelumab should be continued until there is disease progression or unacceptable toxicity. Patients could continue treatment if they have radiological disease progression that is not associated with significant clinical deterioration (defined as no new or worsening symptoms, no change in performance status for more than 2 weeks and no need for salvage therapy). In November 2019, the approved dose was changed to the dose described in the summary of product characteristics.
Price
2.3 The list price of avelumab is £768 per 200-mg vial (excluding VAT; Monthly Index of Medical Specialities [MIMS] online [accessed January 2018]). The average cost of treatment per patient is £65,086 based on the list price. The company has a commercial arrangement. This makes avelumab available to the NHS with a discount. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.