The UK's cost containment agency, the National Institute for health and Clinical Excellence (NICE), has issued draft guidance saying that while Roche's blockbuster cancer drug Avastin (bevacizumab) delays the spread of ovarian cancer when used in combination with paclitaxel and carboplatin, it is not recommend as a cost-effective treatment.
NICE's Appraisal Committee concluded that Avastin in combination with the other two cancer drugs showed a difference in median progression-free survival benefit of between 3.8 and 6 months, but based its negative recommendation on the fact that Roche did not provide a discounted price-known as a Patient Access Scheme-for the drug. Roche estimated the cost of bevacizumab (excluding VAT and assuming there is some wastage of the drug) to be £36,078 for a patient weighing 60 kg at a dosage of 15mg/kg every three weeks. This would amount to an average monthly cost of £2,577.
Ovarian cancer is the fifth most common cancer in women in the UK. In 2009 (the date for which the most recent figures are available), there were nearly 7,000 new cases of ovarian cancer diagnosed in the country.
Avastin, which is Roche's third best-selling drug, generated sales of 4.31 billion Swiss francs ($4.55 billion) during the first nine months of 2012. In 2011, the ovarian cancer drugs markets in key countries (the USA, the UK, Germany, France, Italy, Spain, Japan, Brazil, Russia, India and China) were collectively worth $736.7 million, according to Market Insights, and are expected to witness three-fold growth by 2020, reaching $2.35 billion at a compound annual growth rate (CAGR) of 13.8%.
Roche said it was disappointed in NICE's decision, but would work with the agency to win the regulator's backing. "Avastin is the first drug for 15 years that has been shown to improve outcomes for women with advanced ovarian cancer, and can halt the progression of the disease for up to six months compared to chemotherapy alone," the company said. Roche noted the drug was approved by the European Medicines Agency (EMA) for the treatment of advanced ovarian cancer in combination with standard chemotherapy in December 2011.
Public consultation on the guidance is open until 22 January 2013, after which NICE will make a final decision.
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