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NICE Rejects Cancer Drug Avastin, Life-Extending but Too Expensive

The National Institute for Health and Clinical Excellence (NICE) ruled that Avastin (trade name for bevacizumab) is not a cost-efficient treatment for colorectal cancer, and therefore should not be prescribed by the English and Welsh NHS. Despite clinical evidence from drug-maker Genentech/Hoffmann-La Roche that Avastin, when coupled with other chemotherapies, can extend patients' lives by an average of six weeks, NICE decided that at a cost of £21,000 (US$33,362) per person per year, Avastin is too expensive for the NHS. While NICE maintains that other, less-costly therapies are available, oncologists, patient advocates, and cancer charities have criticized the ruling, highlighting its availability elsewhere in Europe, in addition to its proven efficacy. They have further argued that, in addition to prolonging life for six weeks, Avastin, in combination with other drugs, can reduce the size of liver tumors in 78 percent of patients, who would then be able to receive surgery to remove the tumor.

Critics hope that the new Cancer Drug Fund, to be established in April 2011 with £200 million (US$318 million) achieved through efficiency savings, may enable patients to access Avastin. The Fund will cover oncology treatments that NICE has not approved or not yet considered, as well as "off label" prescribing. £50 million (US$79 million) in interim funding, spent at the discretion of doctors, will be available from October 2010 through next April. At its current cost, £136.5 million (US$216.9 million) would be needed to cover the 6,500 patients eligible for Avastin treatment per year, and alone would bankrupt the Fund, further highlighting the drug's enormous cost.


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