Drug for kidney cancer patients turned down as too expensive

The National Institute for Health and Clinical Excellence (Nice) confirmed it was turning down everolimus (Afinitor) despite a new scheme proposed by manufacturer Novartis to help with costs.

In the latest guidance, which Novartis plans to appeal against, Nice said the drug did not give patients enough benefit to justify its cost.

Research suggests everolimus extends life by three months on average compared to current best standard of care.

But at 99 per day per patient, before any manufacturer discounts, the watchdog judged it to be too expensive.

Patients typically take the drug for 4.9 months, clinical trial data suggests.

Mike Hobday, head of policy at Macmillan Cancer Support, said the news was "frustrating", especially as advanced kidney cancer patients had already been denied four treatments.

He continued: "Everyone should get the clinically effective drugs their doctor recommends, regardless of what type of cancer they have.

"Yet people with rarer cancers aren't being given access to the treatments their doctors believe will improve the quality and length of their life.

"We believe that the Government's cancer drugs fund in England, established at 50m this financial year and 200m next year, will work towards addressing this issue.

"But Macmillan wants the Government to ensure that the new fund includes a focus on treatments for rarer cancers, so that the NHS will support patients whatever cancer they have. We want NHS support to be fair and equal."

Sir Andrew Dillon, chief executive of Nice said the appraisal committee had looked at a new deal from the manufacturer to give patients access to the drug as well as further cost analysis.

"However, the committee felt that there was still too much uncertainty around how cost effective everolimus is to enable the committee to recommend the drug," he said.

"We know that patients with renal cancer want to try all the treatment options and are disappointed not to be able to recommend everolimus as a second line treatment option.

"However, we have to ensure that the money available to the NHS, for treating cancer and other conditions is used to best effect, particularly when NHS funds, like the rest of the public sector, is under considerable financial pressure."

Every year more than 8,000 new cases of kidney cancer are diagnosed in the UK and almost half will result in death.

Around four out of 10 patients are diagnosed when their cancer is at an advanced stage.

Novartis said the drug was available in other countries including – in Europe – Belgium, Denmark, Germany, Finland, France, Greece, Ireland, Luxembourg, the Netherlands, Slovakia, Spain and Switzerland.

Panos Alexakos, oncology general manager for Novartis UK and Ireland, said: "It appears that the Nice process does not take into account the full value of oncology medicines."

He said robust data demonstrated the clinical and cost-effectiveness of everolimus.

The company strongly believed the drug fell within the cost boundaries which Nice used to appraise end-of life-drugs, he added.