Cancer drug too expensive for NHS

A chemotherapy drug that extends the lives of men with advanced prostate cancer is too expensive for use on the NHS, according to draft guidance.









The National Institute for Health and Clinical Excellence (Nice) said cabazitaxel (Jevtana), in combination with prednisone or prednisolone was not cost-effective as a second line treatment after hormone therapy.



The drug has been shown to extend the lives of men with advanced prostate cancer by around 10 weeks.



Sir Andrew Dillon, chief executive of Nice, said: "When assessing the cost-effectiveness of a treatment, Nice appraisal committees will take numerous factors into account.



"These include how effective the drug is, its side effects, the effect it can have on the patient's quality of life and also the financial cost.



"This enables them to determine the cost of using the drug to provide a year of the best quality of life available or quality adjusted life year (QALY).



"Appraisal committees will normally recommend treatments that cost around £30,000 per QALY or less.



"Although cabazitaxel has been shown to be effective, it is also associated with a number of adverse events.



"The committee was particularly concerned about the uncertainty around the effect on patients' renal and cardiac systems.



"It was also concerned about the validity of the health-related quality of life information provided by the manufacturer.



"The committee also felt that the treatment did not meet the criteria to be considered under Nice's special arrangements for end of life, as based on the current data the length of the life extension could not be considered robustly proven to be at least three months.



"Once all these factors had been taken into account it was estimated that the cost per QALY would be more than £89,000.



"Therefore the committee concluded that cabazitaxel would not be a cost-effective use of limited NHS resources."



The decision is now open to consultation.



Doctors could still apply for the drug through the Government's cancer drugs fund.



Cabazitaxel is reportedly one of the drugs used to treat Lockerbie bomber Abdelbaset Ali Mohmed Al Megrahi, who is still alive two years after he was allowed to go home to Libya on compassionate grounds.



Megrahi was released from Greenock Prison after doctors advised he had around three months to live following his diagnosis for terminal prostate cancer.



Today's announcement comes after experts suggested dying cancer patients should be spared "futile" and expensive treatment which can offer "false hope" in the last weeks of life.



Warning of a tendency to "overdiagnose, overtreat, and overpromise", they said the medical profession had created a set of "unrealistic expectations" with regard to the disease.



In an article in The Lancet Oncology journal, the group said burgeoning cancer costs were being driven up by an ageing population and the rapid development of new medicines and surgery.



Led by Professor Richard Sullivan, of King's College London, they said developed countries were now heading towards a "crisis in medical care delivery".



They wrote: "Special consideration must be given to costs of cancer care at the end of life.



"Many forms of cancer are currently incurable and patients will eventually die from their disease.



"If we could accurately predict when further disease-directed therapy would be futile, we clearly would want to spare the patient the toxicity and false hope associated with such treatment, as well as the expense."



Owen Sharp, chief executive of the Prostate Cancer Charity, said: "Cabazitaxel is an important treatment, only recently licensed for use here in the UK, which can help to extend the lives of men in the final stages of prostate cancer for whom existing treatments have stopped working.



"These men currently have very few treatment options open to them when their cancer reaches this advanced stage.



"Increasing the number of treatments that may extend the lives of these men and allow them to spend precious time with their families is essential.



"We believe that every man with prostate cancer must be able to access any licensed treatment for the disease, if their doctor believes it will be beneficial.



"It is disappointing to see that Nice does not believe that cabazitaxel is a treatment it can recommend at this stage.



"It is important to remember that this announcement is not final, and that the appraisal process is still ongoing.



"We hope that further data on the difference this drug can make to the quality of life for men with advanced prostate cancer will help to strengthen the case for Nice to recommend that it be made available to men across England and Wales on the NHS.



"We hope that the drug's manufacturers are able to supply this information so that Nice can consider this new data as soon as it ready."

PA

News
More than 90 years of car history are coming to an end with the abolition of the paper car-tax disc
newsThis and other facts you never knew about the paper circle - completely obsolete tomorrow
Arts and Entertainment
Gay and OK: a scene from 'Pride'
filmsUS film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
News
people'I’d rather have Fred and Rose West quote my characters on childcare'
Arts and Entertainment
Hilary North's 'How My Life Has Changed', 2001
booksWell it was good enough for Ancient Egyptians and Picasso...
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Life and Style
Magic roundabouts: the gyratory system that has excited enthusiasts in Swindon
motoringJust who are the Roundabout Appreciation Society?
Sport
footballManchester City 1 Roma 1: Result leaves Premier League champions in danger of not progressing
Life and Style
The new Windows 10 Start Menu
tech
Travel
Bruce Chatwin's novel 'On the Black Hill' was set at The Vision Farm
travelOne of the finest one-day walks you could hope for - in Britain
News
Kim Jong Un gives field guidance during his inspection of the Korean People's Army (KPA) Naval Unit 167
newsSouth Korean reports suggest rumours of a coup were unfounded
News
i100
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Commercial Litigation NQ+

    Very Competitive Salary: Austen Lloyd: NORTH HAMPSHIRE NQ to MID LEVEL - An e...

    MANCHESTER - SENIOR COMMERCIAL LITIGATION -

    Highly Attractive Pakage: Austen Lloyd: MANCHESTER - A highly attractive oppor...

    Senior Marketing Manager - Central London - £50,000

    £40000 - £50000 per annum: Ashdown Group: Marketing Manager (Campaigns, Offlin...

    Head of Marketing - Acquisition & Direct Reponse Marketing

    £90000 - £135000 per annum: Ashdown Group: Head of Marketing (B2C, Acquisition...

    Day In a Page

    Pride: Are censors pandering to homophobia?

    Are censors pandering to homophobia?

    US film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
    The magic of roundabouts

    Lords of the rings

    Just who are the Roundabout Appreciation Society?
    Why do we like making lists?

    Notes to self: Why do we like making lists?

    Well it was good enough for Ancient Egyptians and Picasso...
    Hong Kong protests: A good time to open a new restaurant?

    A good time to open a new restaurant in Hong Kong?

    As pro-democracy demonstrators hold firm, chef Rowley Leigh, who's in the city to open a new restaurant, says you couldn't hope to meet a nicer bunch
    10 best children's nightwear

    10 best children's nightwear

    Make sure the kids stay cosy on cooler autumn nights in this selection of pjs, onesies and nighties
    Manchester City vs Roma: Five things we learnt from City’s draw at the Etihad

    Manchester City vs Roma

    Five things we learnt from City’s Champions League draw at the Etihad
    Martin Hardy: Mike Ashley must act now and end the Alan Pardew reign

    Trouble on the Tyne

    Ashley must act now and end Pardew's reign at Newcastle, says Martin Hardy
    Isis is an hour from Baghdad, the Iraq army has little chance against it, and air strikes won't help

    Isis an hour away from Baghdad -

    and with no sign of Iraq army being able to make a successful counter-attack
    Turner Prize 2014 is frustratingly timid

    Turner Prize 2014 is frustratingly timid

    The exhibition nods to rich and potentially brilliant ideas, but steps back
    Last chance to see: Half the world’s animals have disappeared over the last 40 years

    Last chance to see...

    The Earth’s animal wildlife population has halved in 40 years
    So here's why teenagers are always grumpy - and it's not what you think

    Truth behind teens' grumpiness

    Early school hours mess with their biological clocks
    Why can no one stop hackers putting celebrities' private photos online?

    Hacked photos: the third wave

    Why can no one stop hackers putting celebrities' private photos online?
    Royal Ballet star dubbed 'Charlize Theron in pointe shoes' takes on Manon

    Homegrown ballerina is on the rise

    Royal Ballet star Melissa Hamilton is about to tackle the role of Manon
    Education, eduction, education? Our growing fascination with what really goes on in school

    Education, education, education

    TV documentaries filmed in classrooms are now a genre in their own right
    It’s reasonable to negotiate with the likes of Isis, so why don’t we do it and save lives?

    It’s perfectly reasonable to negotiate with villains like Isis

    So why don’t we do it and save some lives?