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NICE rejects cancer drug in clash with Roche

Thu Jun 26, 2008 9:36am BST

LONDON/ZURICH (Reuters) - Roche's cancer drug Avastin will not be made available for use on Britain's state health service because the Swiss drugmaker has refused to provide enough information to assess its cost-effectiveness.

The National Institute for Clinical Health and Excellence (NICE) said on Thursday it was unable to recommend first-line use of Avastin in lung and breast cancer after Roche failed to submit clinical and cost effectiveness evidence.

The move highlights a continuing clash between drug companies and the cost-effectiveness watchdog over access to expensive modern cancer medicines.

Targeted drugs like Avastin can extend life by some months but their high price means healthcare providers have to make difficult rationing decisions. In England and Wales, NICE is responsible for those choices by assessing which treatments are worth using on the state-run health service.

"We will issue advice to the NHS (National Health Service) which will say that 'NICE is unable to recommend the use of the technology'," NICE Chief Executive Andrew Dillon said in a statement.

"Of course, if sufficient evidence does become available in the future, we may take the opportunity to review and to revise our advice to the NHS."

Avastin is a blockbuster for Roche and its U.S. partner Genentech. It has been welcomed as a significant advance in treatment by oncologists but its cost of around 3,600 pounds a month for typical lung or breast cancer patients means its use puts a strain on healthcare budgets.

NICE had already decided in an earlier evaluation that Avastin was not cost-effective in colorectal cancer, even though it costs only about half as much in that setting.

Roche UK spokesman Greg Page confirmed the company had decided not to provide lung and breast cancer data because it was clear Avastin would not meet NICE's targets.

"There is a strict cost-effectiveness threshold in the UK and we felt it wouldn't be worth having everybody engaged for a year when it was obvious what the outcome would be," he said.

Worldwide Avastin sales hit 4.1 billion Swiss francs (2 billion pounds) last year and are expected to increase rapidly in the coming years, given the medicine's potential in a range of tumour types.

Many industry analysts believe it could become the biggest-selling drug worldwide by early next decade, with annual sales of more than $10 billion (5 billion pounds).

(Reporting by Ben Hirschler, Katie Reid and Andrew Thompson; editing by Sue Thomas, Paul Bolding)

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