Avastin for 1st line treatment - NICE says no!

[LouiseOvacome]

Dear All,

Sadly the news from NICE towers is not good. They have declined Avastin as a treatment for 1st line ovarian cancer treatment. The reasons for this are complex, and we wanted to share them with you.

Avastin has been proven to be an effective treatment for ovarian cancer, both in the first line, and in relapsed disease.When considering a treatment one looks to research findings, both for progression free survival (PFS) and overall survival. (OS)

Avastin has demonstrated in clinical studies benefit for these indications, however studies alone do not give us the whole picture. NICE has to consider whether or not a treatment is cost effective, and on this measure Avastin has failed the NICE criteria.

Ovacome made a robust defence, arguing that Avastin offered a step change in treatment paradigms, and the any advance should be available, however the sums did not add up.

The most important thing right now is that women on Avastin will continue to receive it, and that Avastin will remain to be available via the cancer drugs fund (CDF). We are hopeful that a review toward the end of the year will ultimately acknowledge that Avastin at the UK preferred dose is a cost effective intervention.

We will keep you updated as news occurs.

L x

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Thank you for posting this information love x G x

[nandi]

Very disappointing! There are many women on the Inspire website who have received Avastin in the relapsed (some many times) setting who have had good benefit. When nothing else has worked. It seems to be particularily good at getting rid of Ascities.

Many thanks for posting.

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I appreciate some drugs such as Avastin is more expensive and can become one of the reasons for it being declined by NICE. My point is to these super rich drug manufacturers, surely its better to offer these breakthrough treatments at a cut down price, get it passed by NICE and then profit from the vast volume of sales on the NHS. Why score an own goal whereby the NHS (the largest customer in the UK) decline to buy the treatment. Surely the profit margins would improve if the NHS were a customer. Just a rant on my part. Rgds

[HumbleD]

Thank you for this news. It is devastatingly to read that the biggest breakthrough for treatment of OC in fifteen years is likely to be declined by NICE.

Love Wendy x

[Whippit]

Dear Louise

I wonder if you would mind clarifying whether this affects the decision to authorise Avastin in the devolved administrations? We're aware the Scottish Assembly rejected the use of Avastin even though it is currently approved by NICE. Can the devolved administrations therefore decide to authorise Avastin despite it not meeting the NICE criteria?

Any light you can shed on this conundrum would be much appreciated. I for one would be prepared to relocate, if necessary, to obtain the best treatment.

Many thanks, Annie

[LouiseOvacome My Ovacome Team]

Hi Annie,

The Scottish equivalent to NICE is the SMC - Scottish Medicines Consortium. They have given a negative determination to Avastin in both 1st line and relapse settings. Wales and NI do not have strictures which appraised drugs in the same way as NICE, but tend to take the foundation work that NICE does as the basis for local decision making. I am not aware of any incidence when Wales or NI have been giving access to treatments which did not 'pass' NICE.

That said, this is a highly unusual situation. NICE were unable to consider the preferred dose of 7.5 mgs/kg as the licence from Europe was given at the higher dose of 15 mg/kg. Subsequent to the licence the ICON 7 data demonstrating PFS at 7.5 was published. Given that ICON7 was a trial which was conducted widely across the UK, and something that the clinical teams were comfortable with, we all wrote to NICE over a year ago asking them to make an exception and consider 7.5 mg outcomes. They have declined to do so. This has been very frustrating, however there is a glimmer of hope in that there is new ICON7 data due at the end of the year, and NICE will be sent this with a view to a kind of 'side' review. There is not as far as I am aware any reason why Wales & NI cannot make a determination based on the ICON 7 (7.5mg dose) data, so we will have to do what we can to ensure that they are not hamstrung to the same extent that NICE have been.

L x

[poleglass in reply to LouiseOvacome]

thank you for this info louise. When I meet the n.ireland health minister mr. Poots, I am certainly going to bring this up with him at my meeting on the 19th. april. what price can you put on a womens life. makes me mad when you think of all the frivoulous money spent on buying new footballers govement bodies trips abroad e.t.c. cancer drugs are away down in the pecking order especially ovarian cancer. . the fact we have had no new drug regime in 20 yrs, says it all rant over.xx

[leftleg1]

This is most disappointing. Can you advise if someone wanted to go down the self funding route for Avastin ( having been turned down twice by the Cancer Drugs Fund) if they could request the lower dose given the European licence? Would it be cheaper than the £25K cost previously suggested?

[LouiseOvacome My Ovacome Team in reply to leftleg1]

Hi,

I'm not sure, but we can find out for you. I am on leave at the moment, but if you call the office, explain this thread, and ask them to contact Roche on your behalf (Pharmas cannot speak to you directly) we can find out for you.

L x