Cancer patients denied 'life' drug

Bevacizumab (Avastin) can help patients with advanced bowel cancer which has spread to other organs, usually the liver and lungs. However, the National Institute for Health and Clinical Excellence (Nice) said yesterday it had considered the drug, including the scheme put forward by manufacturer Roche, but still thought the price was too high for the potential benefit.

Avastin is not a cure but has been shown to typically give people an extra six weeks of life when added to the chemotherapy drugs capecitabine and oxaliplatin.

Research shows patients typically live 21.3 months compared with 19.9 months with chemotherapy alone and data also suggests the trio of drugs means 78 per cent of patients see their tumours shrink to such a degree that they are eligible for potentially life-saving surgery.

Avastin costs almost 21,000 per patient and an estimated 6,500 people in the UK could have been eligible to try the drug.

Nice chief executive, Sir Andrew Dillon, said: "Bevacizumab is a very expensive drug and so patients and NHS should expect substantial benefits from using it. The evidence we have suggests that patients receiving bevacizumab and chemotherapy for this indication may survive on average for six weeks longer than patients receiving chemotherapy and placebo.

"This means half of those patients who receive any benefit will receive less than six extra weeks of life."

Manufacturer Roche initially proposed a patient access scheme where the drug would cost the NHS 20,800 per patient for one year and would be free after 12 months. The cost of oxaliplatin, a chemotherapy drug, would also be reimbursed. A new proposed scheme included all these elements plus an additional upfront payment to the NHS for each person.

Sir Andrew said both Nice and the Department of Health felt the new proposal was complex and the costs had been underestimated by Roche.

Patients may still be able to access the drug through the Government's new cancer drugs fund, which currently holds some 50m, and an extra 200m will be available from April. Regional panels of doctors and cancer specialists are in charge of deciding which patients should benefit from the cash.

Campaigners voiced frustration, however, that Nice was seemingly putting costs ahead of patient need.

Ian Beaumont, campaigns director at Bowel Cancer UK, said: "We are naturally disappointed that Nice has confirmed that it is not approving bevacizumab for use on the NHS, especially 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 introduction of the interim drugs fund last month and the planned introduction of a full cancer drugs fund from April next year will enable patients and their clinicians to gain greater access to effective treatments like bevacizumab on the NHS. This will help to create a fairer, more timely and more efficient system, that puts patients' health needs first."

Yesterday's document is the last draft stage before final guidance is issued to the NHS, but the Department of Health said stakeholders still had the chance for appealing the decision.

Patient Barbara Moss, from Worcester, was among those who addressed the Nice committee assessing the drug. She paid for it privately, using her pension fund in a move that also left her having to cover the costs of her entire treatment. Eventually, her local Primary Care Trust agreed to refund two thirds of the 21,000 costs.

"Nice wastes time talking about silly matters like administrative costs, when that isn't what's really important," she said. "The rest of Europe are using this drug and their cancer survival rates are so much better than in the UK."