August 7, 2008
Cancer Experts Hit Out at NHS Denial of Vital Kidney Drugs
By Emma Brady
Midland cancer experts have hit out at a decision to deny kidney cancer patients four drugs under new NHS guidelines issued yesterday.
The National Institute for Health and Clinical Excellence (Nice) issued draft guidance rejecting the drugs Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) which cost between pounds 20,000 and pounds 35,000 per patient per year.
This leaves just one cancer drug, interferon, to which many patients do not respond.
Professor Lawrence Young, head of Cancer Research UK's Institute for Cancer Studies at Birmingham University, said Nice's decision brings the spotlight back on the need to find an alternative way of approving and funding new cancer drugs.
Prof Young said: "It's very difficult for us to feel despondent when we hear news like this while trying to develop new drugs.
"I realise there's a significant issue with new drugs, they're expensive and the Nice approval process may not necessarily be the best way to decide whether they are funded or not.
"While not all patients respond to these drugs we need to look at ways of delivering more targeted therapy, as we already can with some breast cancer patients."
He added: "It was hoped that the new Cancer Plan would bring an end to all 'ping-pong' situation like we had with Herceptin, where a patient caused a fuss the media gets involved and the PCT eventually relents, it shouldn't have to be like that.
"Therefore it is sad we've not broken out of that cycle yet as these arguments over which drugs are funded and which are not come round every few months, we need to form a new approach to this.
"I accept Nice have a difficult job to do and has to make difficult decisions across all new drugs and treatments.
However I think under the Cancer Plan we would be looking at how vital cancer drugs are funded and distributed. It's a real shame that were still at this point."
Dr Emilio Porfiri, senior lecturer in Medical Oncology at University Hospital Birmingham, in Edgbaston, also admitted he was "extremely disappointed" by Nice's decision.
He said: "These recommendations are provisional, therefore I hope that Nice will consider all the clinical evidence and the opinions of leading clinicians across the UK, and change their minds
"These new drugs are vital treatments for kidney cancer, in particular Sutent. If patients are denied access to these drugs their hopes for a longer survival will be taken away."
The draft guidance, which is subject to appeal, rejects the drugs by claiming they are not cost effective for patients with advanced and/or metastatic kidney cancer.
Although the four drugs do not cure kidney cancer they can extend a person's life by a matter of months.
Nice added that patients already on the therapies should continue until they and their doctors consider it appropriate to stop.
Every year about 7,000 people in Britain are diagnosed with kidney cancer, of which 1,700 will have advanced kidney cancer and at any one time around 3,600 people are living with the advanced form of the disease.
Professor Peter Littlejohns, clinical and public health director at Nice, said: "The decisions Nice has to make are some of the hardest in public life.
"NHS resources are not limitless and Nice has to decide what treatments represent best value to the patient as well as the NHS.
"Although these treatments are clinically effective, regrettably, the cost to the NHS is such that they are not a cost-effective use of NHS resources.
"Two of the manufacturers have developed proposals which may have the effect of reducing the cost of the drugs.
We will be happy to consider these proposals once they have been reviewed and considered suitable for the NHS, by the Department of Health."
It is sad we've not broken out of that cycle yet as these arguments over which drugs are funded and which are not come round every few months.
Prof Lawrence Young
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