Despair as drug ruled too expensive

8:49am Thursday 7th August 2008

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Oxfordshire's postcode lottery cancer victims were dealt a devastating blow this morning after new guidance ruled the life-extending drug Sunitinib was too expensive for the NHS.

Twenty people in Oxfordshire have been denied the drug by the county's primary care trust despite it being available in other areas, and many had vowed to fight the 'postcode lottery' over treatment.

But today the National Institute for Health and Clinical Excellence (Nice) issued draft guidance rejecting four drugs, including Sunitinib, because they were considered not cost effective.

The other three are Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus).

Campaigners say Sunitinib extended the lives of sufferers with advanced kidney cancer.

The draft guidance, which is subject to appeal, rejects the drugs, saying they are not cost effective for patients with advanced and/or metastatic kidney cancer.

The annual cost for Sunitinib is about £32,000 per patient per year, according to Nice.

The guidance said people already on the therapies should continue until they and their doctors consider it appropriate to stop.

Clive Stone, a kidney sufferer who is leading the Oxfordshire campaigners, said this morning he was devastated at the decision.

Charities expressed outrage at the decision, saying it left patients only one treatment option - interferon - to which many do not respond.

Broadcaster James Whale, who lost a kidney to cancer in 2000, said the guidance would "mean an early death sentence for many" if it was not revised.

Every year, up to 7,000 people in the UK are diagnosed with kidney cancer.

Of these, around 1,700 patients will be diagnosed with advanced kidney cancer and at any one time around 3,600 people are living with the advanced form.

Professor Peter Littlejohns, clinical and public health director at Nice, said: "The decisions Nice has to make are some of the hardest in public life.

"NHS resources are not limitless and Nice has to decide what treatments represent best value to the patient as well as the NHS.

"Although these treatments are clinically effective, regrettably, the cost to the NHS is such that they are not a cost-effective use of NHS resources.

"Two of the manufacturers have developed proposals which may have the effect of reducing the cost of the drugs. We will be happy to consider these proposals once they have been reviewed and considered suitable for the NHS, by the Department of Health."

Oxfordshire PCT has said it only considers prescribing the drug when a patient's clinical circumstances differ significantly from the general population of patients and they are likely to benefit from the treatment more than an average patient.

Only one sufferer, Stephen Dallison, 33, is known to have won his appeal against the PCT's decision.

He has said he is responding well to the treatment in the past.