Drug for kidney cancer patients rejected on cost

While evidence shows everolimus (Afinitor) is clinically effective, it is "expensive" and there is limited data on how much it can extend people's lives, the National Institute for Health and Clinical Excellence (Nice) said.

The drug is not a cure for kidney cancer but its manufacturer Novartis said it offers patients a longer and better quality of life.

It is suitable for patients who have failed on vascular endothelial growth factor-targeted therapy, a first-line treatment for advanced renal cell carcinoma.

Research from Novartis suggests everolimus more than doubles the time without tumour growth or death compared with a dummy drug (4.9 months compared with 1.9 months).

The drug costs 2,970 for 30 tablets, with an eight-week cycle costing 5,544, according to Nice figures.

Novartis offered a risk-sharing scheme to give patients the first treatment pack for free followed by five per cent off the cost of subsequent packs but this was rejected.

Professor Peter Littlejohns, Nice clinical and public health director, said the draft guidance is open for consultation.

"We are disappointed not to be able to recommend everolimus as a second-line treatment option for patients with advanced renal cell carcinoma," he said. "But NHS resources are limited and Nice has to decide which treatments represent best value to the patient as well as the NHS.

"Although evidence implies that this treatment is clinically effective, there is limited data about how long it can extend life.

"Everolimus is an expensive drug and we have to be sure the evidence on its effectiveness is robust before we recommend it.

"We do not want to divert NHS funds to a treatment that costs more but doesn't help people live longer."

Panos Alexakos, head of the oncology business unit for Novartis UK, said: "We simply do not understand how Nice can justify denying advanced kidney cancer patients access to an effective licensed treatment that will give them a chance for a longer and better quality of life.

"Once again, many advanced kidney cancer patients will have to spend the precious time they have left fighting for access to a treatment that is available in, and reimbursed by, many countries in Europe and in the US."

Novartis plans to challenge the Nice decision.

Mike Hobday, head of campaigns for Macmillan Cancer Support, said: "The preliminary rejection of everolimus is yet another blow for kidney cancer patients who already have limited treatment options following the rejection of three clinically effective drugs last year.

"Drugs for rare cancers, such as kidney cancer, are more expensive to develop than drugs for more common cancers and so are less likely to be approved for use on the NHS.

"It's unacceptable when cancer patients are penalised simply because of the rarity of their condition."

Around 7,000 new cases of kidney cancer are diagnosed in the UK each year.

Rose Woodward, head of patient support at the James Whale Fund for Kidney Cancer, said: "Kidney cancer patients have seen so much money go into the NHS in the past 10 years – so many initiatives, so many targets, so many programmes.

"What we would really like is for every politician, regardless of what party they belong to, to get together with the Department of Health mandarins and to listen, then act on what patients and their families are saying.

"It is ironic and very sad that as Gordon Brown promises one to one care for cancer patients, Nice issues a statement denying clinicians the chance to offer everolimus, a clinically effective 'end of life' treatment for kidney cancer patients."