1.2 This recommendation is not intended to affect treatment with ripretinib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.
Why the committee made these recommendations
Current treatment for advanced GIST, after people have tried the kinase inhibitors imatinib, sunitinib and regorafenib, is best supportive care.
Clinical trial evidence shows that ripretinib increases the time before the cancer gets worse and increases how long people live compared with best supportive care.
Ripretinib meets NICE's criteria to be considered a life-extending treatment at the end of life. But the economic model does not reflect clinical practice about when to change treatment when advanced GIST gets worse. This means it is not in line with how ripretinib would be used in the NHS. It is not possible to work out if ripretinib is cost effective with the available analyses, so it is not recommended.