Anger over cancer drug decision

PharmaceuticalsA life-extending drug hailed as a breakthrough for prostate cancer sufferers is too expensive to be used on the NHS, watchdogs have ruled.

Cabazitaxel, which is marketed as Jevtana, can extend the life of late-stage patients by an average of three months.
The National Institute for Health and Clinical Excellence (Nice), which decides which drugs should be offered on the NHS, has confirmed its original decision in January, rejecting an appeal by the drug's manufacturers Sanofi. But cancer charities said the decision could mean a postcode lottery and effectively prevent thousands of men from accessing life-extending treatment.

Each year around 37,000 men in the UK are diagnosed with prostate cancer and 10,000 die from the disease. It is the second most common cause of cancer death in men, accounting for 13%.

Nice said that while the drug is clinically effective, at £22,000 per patient it does not offer value for money for the NHS, and there are concerns over side-effects.

Nice chief executive Sir Andrew Dillon said: "We need to be sure that new treatments provide sufficient benefits to patients to justify the significant resources the NHS would need to make available.

"Although cabazitaxel can extend life for some patients, its price remains well above what the independent committee appraising this drug considered acceptable, given the benefits it offers. Cabazitaxel is also associated with a number of side-effects, and the committee was concerned about the nature of the health-related quality of life information provided by the manufacturer."

Whenever a new drug is made available, the money to fund it has to come from elsewhere in the NHS. Nice said it must look at the benefit for patients the NHS can get for the money the drug company is asking.

But Professor Jonathan Waxman, of Imperial College London, said the cost argument was false. He said: "This decision seeks to limit what we as clinicians can do for our patients and their families. The cost argument on which Nice bases their decision is false, giving a much higher estimate of true cost than applies in reality.

"As a result, yet another successful and effective cancer treatment is denied our patients, a mortifying blow to cancer care in England. As the only route to access is now the Cancer Drugs Fund, a temporary arrangement that operates very differently around the country, I fear we're heading towards a re-emergence of the postcode lottery."

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