pemetrexed (Alimta)

following a full submission

pemetrexed (Alimta) is not recommended for use within NHS Scotland.

Indication under review: monotherapy for the maintenance treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology in patients whose disease has not progressed immediately following platinum-based chemotherapy.  First-line treatment should be a platinum doublet with gemcitabine, paclitaxel or docetaxel.

In a sub-group analysis of patients with non-squamous NSCLC, progression free survival and overall survival (secondary endpoint) were significantly longer for pemetrexed plus best supportive care (BSC) compared to placebo plus BSC. 

However, the manufacturer did not present a sufficiently robust economic case and their justification of the treatment's cost in relation to its health benefits was not sufficient to gain acceptance by SMC.