Patients fight NICE over cancer fatigue drugs
pharmafile | April 12, 2006 | News story | Sales and Marketing |Â Â Â
Patient groups are fighting to keep drugs available on the NHS, which they say help cancer patients recover after chemotherapy.
NICE has ruled that patients should no longer receive erythropoietin-based drugs for anaemia caused by cancer treatments, after concluding they are not effective enough in treating the condition.
After reviewing the evidence, NICE said trials showed only 50% of patients respond to the treatment, and that the need for blood transfusions is not significantly reduced.
The expert committee also said that there was doubt about the overall safety of the drugs, with some evidence revealing they could encourage the formation of new tumours in patients.
NICE says patients should instead have adjustments made to the cancer treatment regimen, or have iron supplementation and blood transfusions.
But a coalition of patient groups and doctors are determined to fight the guidance, saying it would deny treatment to people in need.
They say around 7 in 10 patients experience anaemia during chemotherapy, and that NICE has failed to take into account its full impact on patients.
"We call on NICE, when it is making its value for money decisions, to also make a value to life judgement and take into full account the impact of anaemia on a patient's life," said Bowel Cancer UK's Julia Kennedy.
"Having anaemia means patients often haven't got the energy to battle their cancer. It is bad enough fighting cancer without having to cope with a condition that can be easily treated."
A recent survey of cancer patients showed that two-thirds of UK respondents received no treatment at all for the feelings of exhaustion that anaemia produces, despite 84% having raised concerns about their condition with a nurse or doctor.
The group says the UK is out of step with the rest of Europe, with UK patients three times more likely to get no treatment for anaemia than those living in France or Germany.
Anaemia is a common cause of severe fatigue in people with cancer, and can prevent them from carrying out everyday tasks.
It can be caused by treatment with radiotherapy or chemotherapy, by the cancer itself, or it may have other causes, such as anxiety or depression.
If NICE's guidance is implemented, it will mean patients will be treated with blood transfusions instead, even though some experts have questioned wisdom of this.
Dr. Atul Mehta, consultant haematologist at Londons Royal Free Hospital said: "Blood is a scarce and precious resource, the demand for which never stops. It is inappropriate for cancer patients to place unnecessary pressure on blood supplies when EPO exists."
There are three types of EPO licensed in the UK for cancer treatment-related anaemia. They are Janssen-Cilags Eprex (epoetin alfa), Roches NeoReocormon (epoetin beta) and Amgens Aranesp (darbepoetin alfa).
Unlike blood transfusions, which are given in hospital, patients can use pen injections to self-administer EPO – a course which costs between 2500-5000 pounds.
NICE concluded that further research was needed to establish the effects of EPO in the management of anaemia induced by cancer treatment, on health-related quality of life, including its effects on fatigue.
NICE is expected to decide on the appeals in June. After this it will consider reviewing the topic again in 2008.
