Thursday 7 August 2008

Kidney cancer drugs too costly for NHS

Four new drugs to treat advanced kidney cancer have been rejected by the government's drugs advisory body as too expensive for use by the NHS, various news sources report today.

Although the drugs were acknowledged to provide "substantial benefits" and were judged to provide "significant gains" in survival, the National Institute for Health and Clinical Excellence (NICE) has refused approval on the grounds that the NHS cannot afford to provide them to patients.

More than 7,000 people are diagnosed with kidney cancer annually in the UK, with around 1,700 of those diagnosed with advanced kidney cancer.

The drugs cost between £20,000 to £35,000 a year per patient, but even at the upper end of this scale the total cost of providing the drugs to all the 1,700 patients for a year - at just under £60m - is a tiny fraction of the £115m every week the government lavishes on the audit-failing EU. Priorities?

The decision to issue draft guidance rejecting Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) has outraged charities, kidney specialists and campaigners.

Experts have reacted angrily to the decision, saying it left them with little option for treating patients.

Although there are treatments available, none of them "cure" advanced renal cell carcinoma or cancer that has spread from the initial tumour. But they can help extend a patients' life by around five to six months.

Quoted in the Times report, John Wagstaff, an honorary consultant in medical oncology at the South Wales Cancer Institute in Swansea and director of the Wales Cancer Trials Network, said there was “no point” in him accepting referrals for people with advanced kidney cancer because about 75 per cent of them “do not gain any real benefit” from interferon. The only other option, he said, was to make patients comfortable in their last months.

The draft guidelines for England and Wales, which are subject to appeal, recommended people already on the drugs should be able to continue therapy.

In the BBC's report, Pat Hanlon from Kidney Cancer UK said that the drugs provide a 'considerable benefit' and Professor Peter Johnson, from Cancer Research UK, said they had shown a small but definite improvement in an illness where there are few alternative treatments.

It's easy to cast NICE as the villian of the piece, but in trying to get the best out of limited resources they have a very difficult job to do.

In reality, in agreeing to pay an unjustifiable 63% extra to the undeserving EU, it is the government and the MPs who voted to approve that deal who are solely to blame when there's no public money left for life-prolonging drugs to be made available on the NHS.