Regulators have again turned down Roche's ($RHHBY) cancer drug Avastin for payment by the National Health System (NHS), this time for use on a recurrent, advanced ovarian cancer. Roche had asked for another review after the price police in December recommended against paying for it. But that doesn't mean patients won't get it. In fact, the drug is one of most prescribed drugs in the country, even though regulators have failed to approve it for payment for any of the 5 areas it is licensed for treatment, such as colorectal and lung cancer.
It is all part of an elaborate cat-and-mouse game among NICE, the U.K.'s drug price regulator, and doctors and the government, PharmaTimes explains. NICE believes the benefits of Avastin are not enough to justify its price. In the case of the ovarian cancer treatment, the cost was estimated at £25,000 for one course for an average patient.
But Avastin is the most frequently paid for drug through England's Cancer Drugs Fund. The government puts an extra £200 million a year into the NHS to cover new oncology treatments that NICE has rejected. The Cancer Drugs fund is set to expire in April of next year, however, leaving the future of Avastin in the U.K. uncertain. Roche has warned that patients may be faced with looking for alternatives if the government no longer finds a way to pay for it.
Avastin has racked up a series of rejections at NICE besides for ovarian cancer. It has been turned down three separate times for metastatic colorectal cancer, once for breast cancer and one time for treatment of kidney cancer. Its lung cancer appraisal was terminated before final guidance was issued. Often NICE has indicated that there were benefits to patients from the drug, but has said they were not great enough to justify the expense to the government.
Sir Michael Rawlins, the former NICE chairman, defended the agency's recurrent rejection of the drug to the PharmaTimes, even in the face of its obvious popularity among practitioners. He called the creation of the cancer fund a "political" decision and said the drug's "benefits are small and its price is very high".
- here's the PharmaTimes story