U.K. cost watchdogs kick Avastin again

The National Institute for Health and Clinical Excellence's final word for Avastin as a breast cancer treatment? No sale. It's the cost-effectiveness gatekeeper's latest rejection for Roche's ($RHHBY) cancer drug, which had been submitted for use in combination with another Roche drug, Xeloda, in patients with advanced disease.

NICE wasn't impressed with Avastin's efficacy in those patients. Nor was it impressed with the drug's price. The data didn't prove that the drug combo improved overall survival or quality of life any more than current treatment, the agency said.

"We can't recommend a drug that has not been shown to work as well as, or better than, current treatments and costs much more," NICE chief Sir Andrew Dillon said in a statement.

NICE routinely draws fire for its rejections of cancer drugs, and its Avastin decisions have been no different. But this assessment comes after FDA pulled the drug's breast cancer indication, and European regulators restricted its use to just one type of chemotherapy.

The company takes issue with NICE's review of Avastin's efficacy data, the Independent reports. Avastin in combination with Xeloda was "proven to be an important treatment option for women who have a particularly aggressive form of breast cancer which has a poor prognosis," a Roche spokeswoman told the newspaper.

Dillon acknowledged that patients with advanced breast cancer might be disappointed by the decision, but he pointed out that several other treatments were NICE-approved for metastatic disease, including Roche's Herceptin and yes, Roche's Xeloda.

As InPharm points out, Avastin has racked up a series of rejections at NICE, including three separate appraisals for metastatic colorectal cancer, one in breast cancer and one in kidney cancer. Its lung cancer appraisal was terminated before final guidance was issued.

- read the statement from NICE
- get more from InPharm
- read the Independent story