Concern over kidney cancer drug ruling

Cancer Research UK has said that it is “deeply concerned” over NICE’s decision to reject four kidney cancer drugs including: bevacizumab, sorafenib, sunitinib and temsirolimus. Following a preliminary review, NICE has ruled that although the drugs are clinically effective, they are not good value for money for the NHS.

Metastatic renal cell carcinoma is a rare form of kidney cancer so there is limited, but robust, clinical data on the best way to treat it and very few treatment options for the disease. But doctors think that because these new drugs could extend a patient’s life, they should have the option to have these treatments.

Cancer Research UK wants to see the way NICE review the value of drugs altered for rare diseases, such as this type of kidney cancer, where clinical benefit is proven but evidence is limited.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “We are disappointed at NICE’s view that although these drugs are clinically effective, their high price means that they are not value for money. These drugs have shown a small but definite improvement in an illness where there are few alternative treatments. If this decision stands it will be very frustrating for cancer patients and their clinicians.

“This decision once again raises questions about whether NICE’s system of appraisal is appropriate for all types of drugs. It is often difficult to get unequivocal research data in rarer cancers, such as metastatic kidney cancer, which have a small patient population. Although we understand that NICE often has to make difficult decisions, in this case there is a clear separation between what NICE finds to be valuable treatment, and clinical and patient opinion. Action is needed to bring these two positions closer together.”

Harpal Kumar, chief executive of Cancer Research UK, said: “Possible solutions include looking at the way that pharmaceutical companies are charging the NHS for drugs, and whether appropriate allowances are being made by NICE to compensate for the lack of large scale trials in these areas. We also need to ensure that further results are sought and that larger trials, in addition to the nine studies supported by Cancer Research UK, are carried out.”

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