2 The technology

2 The technology

Description of the technology

Eribulin (Halaven, Eisai) is a synthetic analogue of halichondrin B, which inhibits tubulin polymerisation. This disrupts the assembly and formation of microtubules, stopping cancer cell division.

Marketing authorisation

Eribulin has a UK marketing authorisation for the treatment of adult patients with locally advanced or metastatic breast cancer who have progressed after at least 1 chemotherapeutic regimen for advanced disease. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting unless these treatments were not suitable.

This appraisal is only looking at locally advanced or metastatic breast cancer that has progressed after 2 or more chemotherapy regimens for advanced disease.

Adverse reactions

The adverse reactions of eribulin include fatigue, alopecia, peripheral neuropathy, nausea, neutropenia, leukopenia and anaemia. For full details of adverse reactions and contraindications, see the summary of product characteristics.

Recommended dose and schedule

The recommended dosage of eribulin as the ready to use solution is 1.23 mg/m2 administered intravenously over 2 to 5 minutes on days 1 and 8 of every 21‑day cycle.

Price

The cost of eribulin is £361.00 per 0.88 mg/2 ml solution for injection vial and £541.50 per 1.32 mg/3 ml solution for injection vial (excluding VAT; British national formulary [BNF] online, accessed September 2016).

The company has agreed a patient access scheme with the Department of Health. This scheme provides a simple discount to the list price of eribulin, 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 does not constitute an excessive administrative burden on the NHS.

  • National Institute for Health and Care Excellence (NICE)