The National Institute for Health and Clinical Excellence (NICE) has released second draft guidance recommending against the use of Roche’s bowel cancer drug Avastin (bevacizumab).
Roche had submitted an amended patient access scheme for the drug to be taken into consideration by the Independent Appraisal Committee following a provisional negative recommendation in November 2009.
NICE’s advisory committee still refused to recommend Avastin, however, saying it was not a cost-effective treatment for metastatic colorectal cancer.
“We have recommended several treatments for various stages of colorectal cancer, including cetuximab for the first-line treatment of metastatic colorectal cancer,” said Sir Andrew Dillon, chief executive of NICE.
“We are disappointed not to be able to recommend bevacizumab as well but we have to be confident that the benefits justify the considerable cost of this drug.”
The drug, which is recommended in the US and elsewhere in Europe, has the potential to extend the lives of patients with advanced colon cancer by several weeks and months.
As stated in Roche’s initial patient access scheme, Avastin would be supplied at a fixed cost of around £20,800 per patient for one year however, with subsequent treatment after 12 months to be free. The revised proposal also suggested an additional upfront payment to the NHS for each person starting first-line treatment with the drug.
It is estimated around 6,500 people a year would be eligible for treatment.
The negative guidance has come under criticism from several organisations, including Bowel Cancer UK. Ian Beaumont, campaigns director for the charity said: “Bowel Cancer UK is naturally disappointed that NICE has turned down bevacizumab for use on the NHS, when there is so much evidence of the treatment’s efficacy and it is so widely available to patients across the rest of Europe.
“We hope, however, that the imminent introduction of the new Interim Drugs Fund and the Cancer Drugs Fund next year will enable patients and their clinicians to gain greater access to effective treatments like bevacizumab on the NHS and help to create a fairer, more timely and more efficient system of doing so, that puts patients’ health needs first.”
A £50m emergency fund aimed at giving patients access to cancer drugs was announced earlier this year by the Department of Health (DH).
Consultees, healthcare professionals and members of the public are able to comment on the preliminary NICE recommendation up to September 15. These comments will be considered at a later meeting where further guidance will be issued.