NICE has published final guidance on the use of everolimus in the second-line treatment of advanced renal call carcinoma (RCC), recommending against its use for this indication within the NHS.  People currently receiving everolimus for the second-line treatment of advanced RCC should have the option to continue treatment until they and their clinician consider it appropriate to stop.

The Committee concluded that there was sufficient evidence that everolimus increased progression-free and overall survival compared with best supportive care.  The exact magnitude of the overall survival gain was uncertain because it was based on modelled data as opposed to data directly observed in the trial; however the Committee accepted that it would be more than 3 months. 

The incremental cost-effectiveness ratios (ICERs) were subject to considerable uncertainty and were high – estimates of the ICER per QALY ranged from £49,300 to £51,700 per QALY gained.   Taking into account both the value of the ICERs and the uncertainty around them, the Committee concluded that it could not recommend everolimus for the second-line treatment of advanced RCC as a cost-effective use of NHS resources. 

The costing statement estimates that approximately 800 people will be affected by this decision each year.