NICE strikes again. The U.K.'s cost watchdog has nixed Roche's Avastin as a first-line treatment for metastatic breast cancer. As with so many other expensive cancer drugs, the National Institute for Health and Clinical Excellence's advisory committee decided that Avastin's benefits weren't worth the $39,400 average cost.
"The clinical trial results for bevacizumab were disappointing in that they were unable to prove definitively that the drug could extend the lives of patients with metastatic breast cancer over and above currently available treatments," Andrew Dillon, NICE's chief exec, says in a statement. "[W]hen bearing in mind the uncertainties over survival rates and quality of life data, the committee concluded that the cost of bevacizumab is too high for the limited and uncertain benefit it may offer patients. The manufacturer has acknowledged that its own calculations on cost-effectiveness were 'optimistic'," Dillon adds.
Roche is trying to expand use of Avastin--now approved for colon, lung and breast cancer--by studying it in other types of the disease. A rejection from NICE could not only affect U.K. sales of the drug, but also weigh on regulators in other European countries, who watch NICE closely.
The NICE committee ruling isn't the agency's last word, however. There's a consultation period. Roche might come back with a cost-sharing agreement--think Johnson & Johnson with Velcade--that's strong enough to change NICE's mind. Indeed, a Roche spokeswoman said the company had submitted a patient access scheme to NICE, Reuters UK notes. The plan has not yet been included in NICE's evaluation as it is still pending approval from the Department of Health.
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