Another cancer drug too dear for Britain: Bowel cancer victims denied life-prolonging care that's free in Europe

08:18 by Editor · 0 Post a comment on AAWR

Bowel cancer sufferers are to be denied a life-prolonging drug on the NHS which is available to patients across Europe and beyond.

Trials show Avastin can extend life by almost two years.

But the Government's rationing body, Nice, says it is not cost-effective.



In what has been dubbed 'passport prescribing', Britain does not allow routine use of the drug while patients in virtually all other EU countries get the drug paid for.

France, Germany, Italy and Scandinavian nations, as well as Australia and Canada, all meet the cost of treatment.

Last week Nice rejected the use of a liver cancer drug on the NHS.

Around 35,000 Britons develop bowel cancer each year, of which 4,000-5,000 with advanced cancer could benefit from the drug.

Avastin, also known as bevacizumab, costs around £18,000 for a course of ten months' treatment given as intravenous infusion with chemotherapy.

The price is similar to that in other countries.

But the complex formula used by the National Institute for Health and Clinical Excellence, which looks at quality of life and overall cost effectiveness, says the annual cost is £36,000.

This breaks the maximum limit set by Nice of £30,000 - a figure which has not changed in ten years despite inflation.

Although the manufacturer Roche devised a subsidy scheme to reduce an original Nice estimate from £62,000 in an attempt to get it approved, this was not good enough.

Nice's decision, which is preliminary, puts Britain in the same category as Latvia, Poland, Albania and Macedonia in not paying for sufferers to use the drug.

Last night patient groups and experts voiced their dismay.

Kate Spall, of the Pamela Northcott Fund, which assists cancer patients denied new therapies, said: 'This is another bad day for cancer patients and another good day for accountants.'

Professor Will Steward, of the Department of Cancer Studies and Molecular Medicine at Leicester University, also said he was disappointed.

'Having Avastin would bring new hope to the many patients for whom this offers a proven increased chance of living longer with a better quality of life,' he said.

Dr Rob Glynne Jones, chief medical adviser of the Bowel Cancer UK charity, called for Nice, the manufacturer and the Department of Health to find a compromise that would allow the drug to be used.

'The clinical efficacy of bevacizumab and its benefit to patients with metastatic colorectal cancer is well proven,' he said.

Patients waiting for a decision on Avastin are forced to plead for special funding from local health bodies or hope that a trial of the drug is running in their area.

Nice, which has been accused of spending more on spin than on evaluating drugs, has often been criticised for banning drugs from NHS use as too expensive.

Last week it decided to reject NHS use of the liver cancer drug Nexavar, which gives patients six months' extra life. The decision is being appealed

It contrasts with the fast-tracking of the breast cancer drug Herceptin after pressure from patients and the intervention of the then Health Secretary Patricia Hewitt.

Ironically, Avastin also treats breast cancer but its use on the NHS is in limbo until the bowel cancer issue is settled.

Last year Professor Mike Richards, the National Cancer Director, called for greater flexibility between Nice and the pharmaceutical industry to make more treatments available to cancer patients.

Bowel cancer patient Barbara Moss, 54, from Worcester, spoke at a Nice review last month about how Avastin had transformed her quality of life.

She was given just five months to live when diagnosed with bowel cancer in November 2006, but is convinced the drug has kept her alive and in remission.

She fought to get back from the NHS almost £14,000 sent on ancillary care, but had to pay £9,000 for the drug itself.

Yesterday she called on Nice to find a way to approve the use of the drug 'so that thousands can benefit from the drug like I did while avoiding financial hardship'.

Avastin works by blocking the blood supply to the tumour, starving it of oxygen and nutrients. Once it has shrunk it can be surgically removed. continues here

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