Bowel cancer drugs ban a scandal, say campaigners
Monday 21 August 2006
Two drugs hailed as a huge advance in treating bowel cancer will not be approved for use on the NHS, the Government's health watchdog said today.
Campaigners said the move by the National Institute for Health and Clinical Excellence (Nice) was a "backward step" and thousands of patients would die early as a result.
The watchdog rejected Avastin (bevacizumab) and Erbitux (cetuximab) for treating advanced bowel cancer, saying the drugs were not cost-effective.
Its last-stage draft guidance could be subject to an appeal but a final version is expected in November.
Hilary Whittaker, chief executive of Beating Bowel Cancer, branded the decision a "scandal" and said the drug was widely available across Europe.
"Why should patients in the UK be worse off than patients in the rest of Europe?," she said. "It just doesn't add up."
Michael Wickham, chief executive of Bowel Cancer UK, said the decision was "further proof that the NHS is simply not working for bowel cancer patients and is overdue a full and comprehensive review".
The Government was content with a £10bn overspend on its controversial IT programme yet patients were denied treatments "that can help them live longer and better lives", he added.
The NHS of 2006 was content for patients to have to go private and "to spend their often limited time and energy fighting bureaucracy rather than the disease", he continued.
Bowel cancer is the third most common cancer in the UK and 35,000 people are newly-diagnosed every year.
Around 16,000 people die from it every year and more than half of new cases reach the advanced stage, which Avastin and Erbitux are designed to treat.
The therapies have been shown to extend survival by an average of five months and work by specifically targeting cancer cells.
Erbitux, which costs around £700 a week, has been shown to shrink tumours allowing the possibility of surgery, but neither drug is a cure.
Dr Mark Saunders, consultant clinical oncologist at the Christie Hospital NHS Trust, said: "Not only is this a sad day for bowel cancer patients, but also for oncologists in the UK, who want to offer their patients the best possible range of treatments.
"In other European countries, oncologists can use Erbitux and get the cost reimbursed. Why should patients and oncologists in the UK be treated any differently? Today's decision signals a backward step for bowel cancer."
The decision was also branded ironic, given that British scientists led the way in Erbitux clinical trials.
Erbitux has been available to Welsh patients since it was approved by Assembly Health Minister Brian Gibbons in June.
But that decision will now be overturned and an Assembly Government spokeswoman said Mr Gibbons was "highly unlikely" to appeal.
Joanne Rule, Cancerbackup chief executive, said pharmaceutical companies also needed to do more to make their treatments meet the Nice affordability threshold.
She added: "There must surely be smarter ways to negotiate on price. We urge the manufacturers, the Department of Health and Nice to meet urgently to find ways to make cancer treatments more affordable.
"Without change, we will simply perpetuate a two-tier system in which important treatments will only be available to those who can afford to pay."
Andrea Sutcliffe, deputy chief executive of Nice, said: "Following consultation on the first draft guidance, our assessment of the evidence, which shows that neither of these drugs represents a good use of scarce NHS resources, has not changed.
"Although bevacizumab does show some increased benefit over standard treatment, the appraisal committee was not persuaded that it was cost- effective in the treatment of metastatic colorectal cancer.
"The evidence available on cetuximab does not compare it with current standard treatment and therefore we are not able to assess whether it is any better than existing treatments or whether the NHS could justify spending money on the drug."
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