Healthy Skepticism Library item: 8816

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Publication type: news

UK's NICE Rejects Costly Roche Lung Cancer Pill
Reuters 2007 Mar 9
http://www.medscape.com/viewarticle/553382

Full text:

LONDON (Reuters) Mar 09 – Roche’s once-a-day lung cancer pill Tarceva is of limited use and too expensive to be given on the state health service, Britain’s main cost-effectiveness watchdog said on Friday.

The final determination from the National Institute for Health and Clinical Excellence (NICE) is in line with a preliminary decision last November.

The ruling leaves England and Wales, where NICE sets guidelines for medicine use, at odds with Scotland, where the product was recommended for use last year.

It will stoke controversy over access to expensive modern cancer treatments, following a row over whether Herceptin, another Roche product, should be given to women with early breast cancer.

Swiss-based Roche — the world’s biggest maker of cancer drugs — denounced the latest NICE action as “perverse and flawed” and said it would appeal, arguing the evidence had not been assessed fairly or appropriately.

NICE Chief Executive Andrew Dillon, however, said the data showed prescribing Tarceva was not an effective use of National Health Service resources when compared with using either Sanofi-Aventis’ Taxotere or best supportive care.

Still, he acknowledged evidence on Tarceva was still emerging and said the NICE decision would therefore be reviewed in February 2008.

He also called for further research to see if certain sub-groups of patients would benefit more from the drug.

Roche said clinical trials had shown Tarceva reduced symptoms of non-small-cell lung cancer, the most common type of the disease, and increased one-year survival rates 41 percent.

Tarceva was licensed and launched in Britain in 2005 at a cost of 1,631 pounds ($3,153) for one month’s treatment.

The medicine belongs to a new generation of “smart drugs”, or targeted therapies, which attack only cancer cells and are tolerated much better than traditional chemotherapy.

Their high cost, however, is proving a headache for governments and insurers around the world who are already struggling to contain rising healthcare costs.