Breast cancer charity condemns 'disastrous' recommendation to block pioneering treatment

The recommendation from the National Institute for Health and Care Excellence to reject Kadcyla is 'disastrous', Breast Cancer Now says

Helen William
Thursday 29 December 2016 00:55 GMT
A nurse performs a mammography on a patient to check for signs of breast cancer
A nurse performs a mammography on a patient to check for signs of breast cancer (AFP)

A breast cancer charity has condemned a controversial draft decision to block a pioneering treatment for the disease from being routinely available on the NHS.

The recommendation from the National Institute for Health and Care Excellence (Nice) to reject Kadcyla was branded "disastrous" and "a huge setback" by Breast Cancer Now (BCN). It has now launched a petition against the decision.

Without any discount, Kadcyla costs £90,831 per patient, based on a three-weekly dose and an average length of treatment of 14-and-a-half months. It is licensed for HER2-positive breast cancer.

Nice has said the cost is "too high".

A Nice committee looked at new data showing people taking Kadcyla - also known as trastuzumab emtansine - could live up to nine months longer than those taking an alternative drug called lapatinib plus capecitabine.

Manufacturer Roche has offered a discount but BCN is hoping for a deeper price cut and for Nice to use a different comparator drug to evaluate Kadcyla's cost-effectiveness.

BCN chief executive Baroness Delyth Morgan accused Nice and Roche of failures which are leaving "secondary breast cancer patients abandoned".

In a statement directed at Nice chief executive Sir Andrew Dillon and Roche Products general manager Richard Erwin, she said: "Responsibility lies on both sides, and such reckless brinkmanship is unfortunately about to rip away one of the best breast cancer drugs in years from patients in desperate need of a lifeline.

"We welcome that Roche have offered a substantial discount, but they must now lower their price even further. However, Nice's decision to use a comparator drug to calculate the cost-effectiveness of Kadcyla that is not even available to patients is wholly inappropriate and must be reconsidered.

"We believe that had an appropriate comparator drug been selected, the discounted price may have seen Kadcyla fall within the cost-effectiveness threshold. This outcome also speaks volumes about a drug appraisal system that is just not working for metastatic breast cancer patients."

BCN is calling on people to urge Nice and Roche to strike a deal to keep Kadcyla available in England.

Kadcyla is currently being funded through the Cancer Drugs Fund (CDF).

Nice is publishing its draft guidance, including its preliminary recommendation on Kadcyla, on Thursday, opening a consultation which runs until January 19. The Nice committee will meet again in February to consider any further comments.

BCN fears the drug will not be available to patients in England in future unless the draft decision is reversed.

Professor Carole Longson, Nice's director of the centre for health technology evaluation, said: "We know that people with cancer place great importance on drugs that can increase their life expectancy.

"For that reason we apply as much flexibility as we can when we look at new life-extending treatments. But the reality is that the price of trastuzumab emtansine is currently too high in relation to the benefits it gives for it to be recommended for routine commissioning in the NHS, even taking into account the end-of-life criteria and the patient access scheme."

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