The UK’s National Institute for Health and Care Excellence (NICE) has issued a preliminary rejection of Merck’s and Pfizer’s urothelial cancer drug Bavencio (avelumab).

NICE, which carries out assessments of treatments for the National Health Service (NHS), said that clinical trial evidence showed the drug can delay disease progression and extend survival when compared with supportive care, but that current cost-effectiveness estimates for the drug are “much higher than what NICE normally considers an acceptable use of NHS resources.”

The European Union approved Bavencio in January as a first-line maintenance treatment for adults with locally advanced or metastatic urothelial carcinoma who are progression-free after platinum-based chemotherapy.