Breast cancer patients are being let down because the NHS watchdog is rejecting new drugs, experts warn.
Nice has not approved a single treatment for the illness in ten years, even though countries such as France and Australia have made them available.
The charity Breast Cancer Now says the watchdog’s method for evaluating new drugs is flawed and places too much emphasis on cost.
This is leading to an ‘intolerable situation’ for breast cancer patients in England and the country is lagging behind other rich nations, it warns. The charity said that out of ten new drugs which have come onto the market since 2007, not a single one was approved by NICE.
These include Perjeta, turned down in May, and Kadcyla, rejected in December 2015, which were both given the green light by Canada, Australia, France and Germany.
These drugs treat a type of breast cancer called HER2-positive, which accounts for around a fifth of all cases. Trials show Kadcyla extends life by an average of six months, but some patients lived for several years. Early research suggests Perjeta can double the likelihood of tumours being eradicated.
Breast cancer survival rates in England are worse than countries such as Norway, Sweden and Canada. Baroness Delyth Morgan, chief executive at Breast Cancer Now, described the system as ‘broken’.
‘The last ten appraisals of breast cancer drugs by NICE have seen ten rejections and this intolerable trend is leaving patients in England behind,’ she said. ‘It is hard to see how any new and improved breast cancer treatments would reach patients in England, despite the research progress being made. Around 9,500 women in England are still losing their lives to breast cancer each year, and we must ensure that new innovations have the best chance of being made available at the best price for the NHS.’
The charity says NICE’s system is flawed because it centres on comparing the cost of a breakthrough new treatment with the price of existing breast cancer drugs. This means new treatments are almost always turned down because they can cost up to £30,000 for a course, whereas the far less effective existing drugs may only be a few pounds a day.
The charity says the watchdog fails to recognise that new drugs have the potential to give women several extra years of life compared to current medicines which may only add a few more months. It is also concerned that NICE has just taken control of the Cancer Drugs Fund, used to pay for treatments not available on the NHS. Previously, patients still had a chance to access drugs rejected by NICE via the fund. But experts now fear more treatments will be turned down.
Sir Andrew Dillon, chief executive of NICE, said the system appraised cancer drugs far more ‘generously’ than those for other conditions.
While he welcomed Breast Cancer Now’s contribution to the debate, he said changing NICE’s appraisal system was not the solution. ‘Any change in our approach?...?has to be accompanied by a sustained and material change in the cost of these drugs to the NHS,’ he added.
Daily Mail