Avastin receives another NICE rejection

Avastin will still not be financed by the NHS for ovarian cancer after NICE rejected their latest request for approval.

In the latest round of draft guidance, the regulatory body confirmed that Roche’s Avastin (bevacizumab) has not been recommended as a NHS treatment for a type of recurrent, advanced ovarian cancer.

This latest decision, which was decided after a public consultation on previous initial recommendations against the drug, again determined that Avastin, when used with Lilly’s Gemzar and carboplatin, does not signify good value for money for the NHS.

NICE’s chief executive, Sir Andrew Dillon, noted that although the independent appraisal committee acknowledged that Avastin may help delay cancer from spreading for a few months, clinical trial data was unavailable for roughly one in three trial members, potentially as a result of the discontinuation of treatment, side-effects or because they had been lost to follow-up, meaning that it was difficult to know what effect this had on the progression-free survival rates.

“The committee also couldn’t be sure the drug would help people live longer.  The current evidence of benefit for patients does not support the cost of the treatment, which the manufacturer estimates to be just over £25,000 for one course for an average patient,” Dillion added.

However, the draft guidance also recommends that patients who are currently receiving the treatment combination should be able to continue until they and their clinician consider it appropriate to stop.

The Institute is also designing recommendations on the use of Avastin to treat the first recurrence of advanced ovarian cancer if it has returned six months or more after initial treatment and if the patient has formerly received platinum-based chemotherapy (platinum-sensitive disease).  The draft guidance is also relevant to women with fallopian tube and primary peritoneal cancer.

Consultees now have the chance to appeal against the draft recommendations.  Otherwise final guidance will be published next month.

However, NICE look likely to come to the same decision as their counterpart, the Scottish Medicines Consortium, which in October concluded that the treatment’s cost in relation to its health benefits was not sufficient, and added that the firm failed to “present a sufficiently robust economic analysis to gain acceptance.”


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