NICE set to deny access to kidney cancer drugs
pharmafile | August 8, 2008 | News story | Sales and Marketing |
Four treatments for advanced kidney cancer have been rejected by NICE even though they show significant clinical benefits.
The Institute's preliminary guidance on Pfizer's Sutent, Bayer's Nexavar, Wyeth's Torisel and Roche's Avastin ruled all were too expensive for the NHS.
Stakeholders have until the end of this month to comment before NICE develops its final guidance, but several have already criticised its approach to assessing drugs for rare cancers.
Pfizer's medical director Dr David Gillen said: "Whilst we recognise that NICE has an important role in recommending medicines that offer greatest value for money to the NHS, we believe that the current appraisal process disadvantages patients with rarer diseases, where it is proportionately more expensive to develop new medicines.
Cancer Research UK says there is an urgent need for new treatments for metastatic renal cell carcinoma (mRCC) and that the four drugs had shown considerable promise in trials.
Writing on the group's blog, Cancer Research UK's Henry Scowcroft said: "We feel [this decision] raises fundamental questions about how NICE evaluates cancer drugs, particularly for cancers that only affect a relatively small number of people."
Approximately 3,000 people are diagnosed with mRCC in the UK each year and the only recommended treatment is interferon.
NICE acknowledged the new drugs have shown varying degrees of clinical effectiveness, noting Avastin and Sutent appeared to have significant benefits compared to interferon as first-line treatments, despite 'immature' survival data.
For patients with poor prognosis, Torisel appears to have significant benefits as well. Meanwhile, as a second-line treatment NICE said Nexavar seemed to have clinically statistically significant benefits – but slightly more adverse events – when compared with best supportive care.
Pricing deals by two companies also failed to sway the argument. Roche proposed limiting the annual cost of using Avastin and Pfizer has offered the NHS a free first cycle of treatment with Sutent.
NICE said patients currently receiving Avastin, Sutent, Nexavar or Torisel can continue to do so until they and their clinicians consider it appropriate to stop.
"For those currently living with advanced kidney cancer and fighting for access to these treatments, this will be devastating news," said Philip Ashman, business unit head of Bayer Schering Pharma Oncology in the UK.
He added that a forthcoming review of co-payments for drugs might now be the only option left to patients.
