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23.04.14

NICE rejects ‘costly’ cancer treatment for NHS use

The National Institute for Health and Care Excellence (NICE) has stated that a breast cancer treatment that costs more than £90,000 per patient is not effective enough to be recommended for routine use in the NHS. 

Draft guidance, published for consultation, says that despite some evidence of clinical efficacy, trastuzumab emtansine (Kadcyla), manufactured by Roche, does not work well enough to justify its high cost. 

NICE has been appraising Kadcyla as a treatment option for people with HER2-positive breast cancer that has spread to other parts of the body, cannot be surgically removed and has stopped responding to initial treatment. 

Sir Andrew Dillon, NICE chief executive, said: “We had hoped that Roche would have recognised the challenge the NHS faces in managing the adoption of expensive new treatments by reducing the cost of Kadcyla to the NHS. 

“This drug is already being funded through the special Cancer Drugs Fund. Our job is to recommend whether it should transfer into the NHS budget. We are very aware of the importance that people place on life-extending cancer drugs and a decision not to recommend a cancer treatment for routine NHS funding is never taken lightly.” 

Emma Pennery, clinical director at Breast Cancer Care, said: “It's extremely disappointing news for those living with advanced breast cancer and their families that yet another treatment has not been recommended by NICE.” 

In making the recommendation on behalf of NICE, the Independent Appraisal Committee considered evidence from the manufacturer, doctors and patient experts. It heard that Kadcyla is most likely to be given as a ‘second-line' treatment and could potentially help to extend life by nearly six months, compared with the treatment combination of lapatinib plus capecitabine. 

However, a course of treatment with Kadcyla is expected to cost £90,831 per patient – tens of thousands of pounds more than other currently available second-line treatments. 

Sir Andrew said: “We hope the manufacturer will act in the best interests of patients and use this consultation period to look again at their evidence and consider if there is more they can do.” 

However, Jayson Dallas, general manager at Roche Products, said: “Roche is extremely disappointed that NICE has failed to safeguard the interests of patients with this advanced stage of aggressive disease.” 

A Department of Health spokesman added that stakeholders would have the opportunity to respond to the recommendations set out in the draft guidelines for England and Wales. 

Consultees, including the manufacturer, healthcare professionals and members of the public are able to comment on the draft recommendations via the NICE website until Monday 19 May 2014. All comments received during this consultation will be considered by the committee and a second draft of the guidance will then be published. If there are no objections at that stage, NICE will publish final guidance to the NHS. Until then, NHS bodies should make decisions locally on the funding of specific treatments. 

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com 

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