Hopes for cancer drug on NHS dashed

The National Institute for Health and Clinical Excellence (Nice) ruled that the benefits of Avastin were not sufficient to justify the "considerable cost" of the drug for patients with advanced bowel cancer which had spread, usually to the liver and lungs.

The decision, which is subject to consultation and appeal, came despite a risk-sharing scheme proposed by manufacturer Roche which would have reduced its expense.

Avastin costs almost 21,000 per patient a year and an estimated 6,500 people per year could be eligible for the treatment. Roche says it can typically offer patients an extra six weeks of life when added to two chemotherapy drugs. Studies indicate patients typically live 21.3 months, compared with 19.9 months with chemotherapy alone.

Data also suggests four in five patients see tumours shrink – so they are eligible for potentially life-saving surgery using the drug, also known as bevacizumab.

The chief executive of Nice, Sir Andrew Dillon, said it recommended several treatments as a first-line treatment for advanced bowel cancer.

"We are disappointed not to be able to recommend bevacizumab as well but we have to be confident that the benefits justify the considerable cost of this drug," he added.

Nice said it thought the costs of administering the drug would be higher than Roche proposed and there were doubts about the overall cost-effectiveness of the treatment, which is part of a new generation of targeted biological agents which help shrink and eliminate tumours.

Campaigners said they hoped the Government's new 50m cancer fund would help those denied the drug.

The chief medical adviser at Bowel Cancer UK, Rob Glynne-Jones, said patients could live up to 27 months in total with Avastin, according to trial data from Europe and the US.

"I can't argue with Nice's decision, but I am disappointed," he said. "These statistics tell their own story and imply that we are likely to fall even further behind in worldwide league tables."

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.

Mrs Moss said: "I am living proof that Avastin works."

"I was a patient at a hospice, dying of advanced bowel cancer; now I am free of the disease and visit my friends there.

"I have seen other people dying of bowel cancer and it hurts. I know, and their families know, that they might have been alive today if they has been given a chance with Avastin, like I was."

Mrs Moss's bowel cancer had spread to her liver but the tumours did not respond to chemotherapy. When she was given Avastin, the tumours shrank completely, allowing her to have surgery and she is now in remission.

She added: "It seems immoral to me that, as a result of negative Nice decisions like this one, people's choice of living or dying depends on whether they can afford a drug because it isn't available to them on the NHS."

A Department of Health spokesman said it understood patients would find the announcement disappointing, but the decision was subject to consultation.

He added: "We have already announced an additional 50m of funding to be available from October, ahead of the 2011 Cancer Drugs Fund, which will help thousands of patients access cancer drugs recommended by their doctors."