...The NICE executives point out that very few British patients participated in the SATURN trial, and that a high proportion of the trial participants had better prognostic factors than those seen in clinical practice in the Untied Kingdom, which could overestimate the efficacy of erlotinib. The results from this trial therefore have "limited generalizability to UK patients," the committee concludes.
In addition, the NICE committee points out that the size of the cumulative population eligible for treatment with erlotinib is "not small."
Economic models based on the SATURN results were used to calculate cost effectiveness. The manufacturer calculated that, compared with best supportive care, the incremental cost-effectiveness ratio for erlotinib maintenance worked out to ₤47,743 per quality-adjusted life year (QALY) gained for patients with stable disease. The NICE committee arrived at a figure of ₤59,336, and concluded that this figure "was the most plausible."
Both calculations are much higher than the upper limit of ₤30,000 per QALY that NICE uses as a cut-off in its appraisals....