NICE rejects Avastin for breast cancer

A drug used to treat breast cancer that has spread has been turned down for routine funding on the NHS by the National Institute for Health and Clinical Excellence (NICE).

Final draft guidance published today states that the benefits of bevacizumab (Avastin) are too small to justify its very high cost.

Sir Andrew Dillon, chief executive of NICE, said: "We know that it's immensely important for breast cancer patients, whose disease has spread, to prolong their lives as much as possible.

"Unfortunately, we did not receive any evidence from the manufacturer to show that bevacizumab can significantly lengthen a patient's life or, importantly, offer a better quality of life than existing treatments. Although the data seemed to show that the drug may slow the growth and spread of the cancer, the size of this effect varied between studies. Furthermore, it was extremely unclear that the benefits in terms of slowing tumour growth translated into benefits on overall survival, which is what really matters for patients."

Roche, which manufactures the drug, estimates that the total average cost per patient of bevacizumab plus paclitaxel (the drug with which it is administered) to be £33,649 compared with around £7,720 for paclitaxel alone.

The United States Food and Drug Administration (which regulates drugs in America) and the European Medicines Agency (which licenses drugs for use in Europe) are both currently reconsidering bevacizumab's license as a treatment for metastatic breast cancer.

The draft guidance is now subject to an appeal process whereby consultees can appeal against the recommendation. Final guidance is expected to be published early next year but until then, NHS bodies will make decisions locally on whether or not to fund the drug.

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