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Provisional negative decision for Avastin

NICE issues preliminary negative recommendation on Avastin for metastatic bowel cancer 
The UK's National Institute for Health and Clinical Excellence (NICE) has issued a provisional negative recommendation on Avastin (bevacizumab) in combination with oxaliplatin-based therapy for the treatment of advanced bowel cancer.
Responding to a call by national cancer director, Professor Mike Richards, for greater flexibility between NICE and the pharmaceutical industry to make more treatments available to cancer patients, the drug's manufacturer, Roche, began working with the UK's Department of Health (DH) to develop a subsidised package of care at a cost per QALY of £36,000. This is just over the commonly accepted NICE threshold of £30,000.
Despite the fact that Avastin-containing regimens are recognised globally as a standard of care for advanced bowel cancer and provide the best possible survival benefit for such patients, NICE has provisionally recommended that Avastin in combination with oxaliplatin-based therapy for the treatment of advanced bowel cancer should not be funded by the NHS, making the UK virtually the only country in the developed world not to provide Avastin for bowel cancer through the state healthcare service.
John Melville, general manager Roche UK, commented: "We are in an unfortunate passport prescribing situation with Avastin whereby patients in Australia, Canada and most of Europe gain access, but patients in the UK, Latvia and Poland don't."

Avastin has a well-established tolerability profile and the most frequently observed adverse drug reactions in clinical trials were hypertension, fatigue, neuropathy and proteinuria. The most common side effects are generally manageable. For example, hypertension can generally be managed with conventional antihypertensive treatment.

Bowel cancer is the second largest cause of cancer deaths in the UK, with more than 37,500 people diagnosed with the disease every year. It is estimated that one in 18 individuals will be affected by bowel cancer in their lives, with men and women being affected equally. 

23rd November 2009


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