Nice rejects 'clinically effective' cancer drug for being too expensive

Cancer charities have slammed the National Institute for Health and Clinical Excellence's (Nice) decision to reject a drug that prolongs the life of prostate cancer suffers for being too expensive.

Nice released its draft guidance saying that abiraterone's cost of at least £63,200 per quality-adjusted life year (QALY) was too much for the organisation to recommend for NHS use.

However, this has been greeted with anger by cancer groups who said the drug had been in high demand from the government's specialist cancer drugs fund and there were almost no effective alternatives available.

The body has rejected several other cancer drugs over recent months, predominantly on the grounds of cost.

While it is not a rigid formula, Nice typically does not recommend treatments that cost more than £20,000 to £30,000 per QALY, with the largest being £50,000 for Sunitinib.

Abiraterone is designed to be used in combination with prednisone or prednisolone for the treatment of castration-resistant metastatic prostate cancer that has progressed on or after chemotherapy.

Sir Andrew Dillon, chief executive of NICE, acknowledged that Abiraterone could potentially extend life by more than three months compared with placebo tests and that noted one of its key benefits was that it can be taken orally at home.

And he expressed disappointment at not to be able to recommend it for use on the NHS.

“However, it is an expensive drug and the independent advisory committee that made this decision did not feel the drug provided enough benefit to patients to justify the price the NHS is being asked to pay, even with the discount that the manufacturer has offered," he said.

The announcement prompted an angry reaction from Cancer Research UK which has urged for a solution to be found over the impasse.

It was particularly concerned by the provisional ruling as Nice had found it was "clinically effective".

Professor Peter Johnson, chief clinician at Cancer Research UK, said: “This decision makes no sense.

“Since it became available in the UK, abiraterone has been one of the most requested treatments from the Cancer Drugs Fund because patients and doctors value the extra months of life it can give if prostate cancer has come back after chemotherapy.

“We need to find a way for it to be routinely available through the NHS.

“At the moment it is too expensive and NICE must find a better way to ensure drugs that are already working for patients get approved,” he added.

The charity noted there were very few other treatment options for men with advanced prostate cancer and that the only one available on the NHS that has been shown to prolong survival has more severe side effects and is effective in fewer men.

It warned that if Nice could not agree a better discount scheme, abiraterone will only be available through the Cancer Drugs Fund in England.

The Fund is only available until 2014 and does not apply to Wales, Scotland and Northern Ireland.