NICE slaps down Roche's Avastin for ovarian cancer

NICE struck down Avastin once again--courtesy of Richard Morgenstein/Genentech

Avastin has struck out at NICE again. The U.K. cost-effectiveness watchdog says it's not inclined to back the blockbuster Roche ($RHHBY) drug as a treatment for ovarian cancer. At about $4,000 per month, NICE said, Avastin simply doesn't deliver enough value for the money.

The sticking point lay in Avastin's ability--or lack thereof--to extend patients' lives. NICE allowed that the drug did hold off the spread of disease in some patients. But whether patients actually live longer isn't clear, the agency said. The refusal in ovarian cancer follows a similar decision in breast cancer in July.

On balance, officials concluded that Avastin's clinical benefits in ovarian cancer aren't significantly better than those of other drugs--or at least not enough to justify the premium. "There was no evidence ... that the clinical benefit of the treatment justifies its cost, when compared to existing treatments," NICE Chief Andrew Dillon said in a statement.

Roche said it would work with NICE to win the agency's backing. A final decision isn't expected till next year. Persuading the agency often involves a "patient access scheme," a.k.a., some sort of price or cost reduction. Roche hasn't made a discount offer--yet.

Whether Roche would propose a reduction large enough to tip the balance remains to be seen. It's clear, however, that the Swiss drugmaker is keen upon extending Avastin's use into new indications; in fact, its hopes for use in ovarian cancer amount to hundreds of millions of dollars. NICE's decision could be influential here, and not only in the U.K. Other governments often look to the agency for guidance in setting their own health-service formularies.

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