Wales sidesteps NICE recommendation on kidney cancer drug access


Welsh patients will be able to receive four kidney cancer drugs that have not been
recommended by the National Institute for health and Clinical Excellence (NICE), the
Welsh health minister Edwina Hart has announced.
The decision will allow greater access to four drugs currently being reviewed by NICE
for advanced renal cancer - Pfizer's Sutent (sunitinib), Genentech's Avastin
(bevacizumab), Bayer's Nexavar (sorafenib) and Wyeth's Torisel (temsirolimus). None
of the drugs was found cost-effective a draft NICE appraisal last August; the assessment
of the treatments has since been extended, with final guidance expected this month
(Scrip Online, October 21st, 2008). However, the health minister has instructed Local Health Boards (LHBs) to provide the drugs to end-of-life patients with kidney cancer, with immediate effect, choosing not to wait for NICE's decision. Although describing the move as a "temporary arrangement", the health minister added it was "unacceptable" for patients to be kept waiting for the treatments.
The decision follows a clinical audit of Sutent issued last December. Originally, NICE
and the All Wales Medicines Strategy Group (AWMSG) issued guidance that the drug
should not be funded by the NHS as it was too expensive (Scrip Online, August 8th,
2008), thus leaving funding decisions to LHBs for individual patients. However, a study undertaken by the Medical Director of NHS Wales Professor Mike Harmer found that of 73 requests for Sutent only 23 received the treatment in 2008, raising questions of consistency; the report revealed that all patients who were recommended the treatment in Neath, Port Talbot and Bridgend received it, while only one of 13 patients received the drug in Cardiff and none of the 14 patients recommended received the drug in Swansea.
The health minister has already shown she is prepared for Wales to make its own
decisions regarding drug availability; in July last year she made Novartis's Lucentis
(ranibizumab) for wet age-related macular degeneration (AMD) in both eyes available
on the Welsh NHS, a month before final guidance for England and Wales was confirmed
by NICE (Scrip Online, July 17th 2008 and August 27th, 2008).
NICE has proposed changing its cost-effectiveness parameters for end-of-life drugs,
partly in response to a public outcry over the initial draft of its assessment of the four
kidney anticancers.

SCRIP - World Pharmaceutical News - www.scrippharma.com
FILED 26 January 2009 COPYRIGHT Informa UK Ltd 2009
PHIND: Pharma & Healthcare Ind News - today only (PHID)

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