Bowel cancer drug appeal rejected

Campaigners have lost an appeal to make a bowel cancer drug widely available on the NHS. Charities Cancer backup and Bowel Cancer UK appealed against a decision by the health watchdog to reject the drug Erbitux (cetuximab) for use on the NHS. The National Institute for Health and Clinical Excellence (Nice) ruled last August that Erbitux was not cost-effective.

And it upheld its decision after considering the appeal. A separate appeal by manufacturer Merck, which helps fund both the charities, also failed.

Bowel cancer is the third most common cancer in the UK, with 35,000 people newly-diagnosed every year. Around 16,000 people die from it every year and more than half of new cases reach the advanced stage, which Erbitux is designed to treat. The drug, which costs around £700 a week, has been shown to shrink tumours allowing the possibility of surgery, but is not a cure.

Announcing the decision, Peter Littlejohns, clinical and public health director, said the committee which made the decision was aware that bowel cancer was an aggressive disease and that treatment options were limited.

But he said it had to balance the additional therapeutic benefit offered by new treatments against their cost. "The assessment of the evidence shows that neither of these drugs represents a good use of NHS resources."

Campaigners branded the NICE decision ironic, given that British scientists led the way in Erbitux clinical trials. Ian Beaumont, from Bowel Cancer UK, said: "This decision demonstrates NICE's continued indifference to people living with advanced bowel cancer.

"No one should be in any doubt that the basis for it is financial and bears no relation to the efficacy of the drug, which is well proven. Erbitux offers hope to patients when other treatments have failed and NICE is taking away that hope. Whilst we are naturally disappointed, we will continue to campaign for this and other valuable treatments, which enable many thousands of people with bowel cancer to live longer and have an improved quality of life."

Professor Alex Markham, chief executive of Cancer Research UK, said the decision was "extremely worrying". We don't understand the cost framework used by NICE to come to this decision and we feel there needs to be a public debate on how much the NHS ought to be spending on any individual cancer patient. The current system lacks transparency and needs an overhaul. As well as a lack of clarity about what the NHS thinks a single life is worth, we need a debate about how drug companies agree their pricing with the Department of Health."

Professor Markham said the UK was one of the slowest countries in Europe to adopt new medicines through the NHS. "Cetuximab has been available to US cancer patients for three years and it is unacceptable that UK cancer patients have had to wait this long for a disappointing decision that they won't understand. Cancer Research UK is committed to making new treatments available and therefore is conducting further research which we hope will ensure that treatments like this are available to UK patients in the future."