Overall survival OS but not progression-free survival PFS was improved for patients treated with eribulin versus capecitabine in this subgroup. However, the ERG identified several problematic issues relating to modelling OS and PFS, drug costing and utility values, and made ten revisions to the company model. Within the STA process, the manufacturer or sponsor provides a written submission alongside a decision-analytic model that summarises the estimate of the clinical effectiveness and cost effectiveness of the technology. The final guidance constitutes a legal obligation for NHS providers in England and Wales to provide a technology that is approved within its licensed indication. In guidance issued by NICE in, eribulin was not recommended as a routine treatment option for these patients in England and Wales. In, the EMA granted an extension to the indication for eribulin enabling eribulin to be used earlier in the treatment pathway. Prior therapy should have included an anthracycline and a taxane in either the adjuvant or metastatic setting unless patients were not suitable for these treatments.

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