The pCODR Expert Review Committee (pERC) has recommended the funding of Mekinist (trametinib) in patients with BRAF V600 mutation-positive unresectable or metastatic melanoma, conditional on the cost-effectiveness of trametinib being improved to an acceptable level. Funding should be for untreated patients or patients previously treated with chemotherapy with ECOG performance status 0 or 1. If brain metastases are present, they should be stable. The Committee made this recommendation because it was satisfied that there is a net clinical benefit of trametinib compared with dacarbazine. However, at the submitted price and the Economic Guidance Panel’s best estimates of the incremental cost-effectiveness ratio, trametinib could not be considered cost-effective compared with dacarbazine. In the absence of a direct comparison, and because of the uncertainty in the indirect comparison with vemurafenib, the uncertainties in clinical benefit and economic analysis were too great for the Committee to determine the net clinical benefit or cost-effectiveness compared with vemurafenib. 

For more details, go to: http://www.pcodr.ca/idc/groups/pcodr/documents/pcodrdocument/pcodr-mekinist-mm-fn-rec.pdf