The rejection by the National Institute for Health and Clinical Excellence (NICE) of the Roche bowel-cancer drug Avastin (bevacizumab) as an NHS treatment may not be the end of the story.
The bevacizumab-based drug has been shown to shrink tumours in 78% of patients when added to chemotherapy drugs capecitabine and oxaliplatin.
It was rejected by NICE even after Roche had offered a patient-access scheme to reduce the cost to £36,000 per quality-adjusted life year (QALY).
However, this is above the £30,000 threshold used by NICE, which rejected the drug in a draft recommendation that concluded it did not offer value for money.
Avastinis is suitable for patients with advanced (metastatic) bowel cancer, where the disease has spread around the body, and could potentially extend the lives of some 6,000 people a year.
Trials have shown that adding the drug to oxaliplatin-based chemotherapy typically increases survival to 21.3 months from 19.9 months with chemotherapy alone.
Roche has now said that it is confident it can continue to work with NICE to make Avastin available.
Meanwhile, Dr Carole Longson, director of the health technology evaluation centre at NICE, said the draft guidance is out for consultation.
However, she said: “The committee felt that the scheme does not reflect routine clinical practice, that the administration costs were likely to be higher than the manufacturer had indicated, and that it was by no means certain that the impact of the scheme on the cost effectiveness of bevacizumab would be in line with the manufacturer’s claims.”
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