Velcade decision outrage

A decision by the National Institute for Health and Clinical Excellence (NICE) not to recommend a bone marrow cancer drug for use on the NHS is the latest guidance by the cost benefit assessment body to cause outrage among patient groups and health charities.

The Institute said that Velcade (bortezomib), a drug co-developed by Millennium Pharmaceuticals and Johnson & Johnson and marketed by Janssen-Cilag in the UK, had not demonstrated proven cost-effectiveness. The announcement had not been expected until October 24, but was brought forward after the ruling was leaked to the press five days earlier.

Stories in the national media focused on the drug's availability in Scotland and condemned the decision to deny it to patients living in England.

Andrea Sutcliffe, executive lead for the Velcade appraisal said NICE was ìextremely concerned about misleading coverageî that appeared in some national newspapers. NICE even made a point of summarising various points raised in newspaper reports and correcting them.

ìIt is one thing to criticise our decision not to recommend the use of the drug, but quite another to unfairly raise patient expectations about the effect of this drug and its availability in other parts of the UK,î she said.

A 2005 trial showed Velcade could extend the life expectancy of a patient by an average of six months more than standard treatment. Treatment costs about £18,000 per patient.

Sutcliffe said the appraisal committee had considered comments received during consultation on an earlier draft and had not changed its conclusion.

ìAlthough the drug is clinically effective compared with high dose dexamethasone, its cost-effectiveness has not been satisfactorily demonstrated and therefore further research is required,î she stated.

A spokeswoman for cancer charity, Myeloma UK, said it was taking legal advice over the NICE ruling.

ìThis represents probably the single biggest setback in the history of the treatment of myeloma,î she commented. ìVelcade is a proven and licensed treatment and, quite simply, no myeloma patient in the UK should die without having access to it.î

Velcade slows the advance of myeloma, with which 4,000 people are diagnosed in the UK each year.