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Scotland ‘no’ to Avastin

Published on 09/10/12 at 09:26am
Avastin image

Roche has slammed the Scottish Medicines Consortium (SMC)’s decision not to recommend Avastin for women with advanced ovarian cancer in Scotland.

Avastin (bevacizumab), in combination with standard chemotherapy (carboplatin and paclitaxel) has been available in the UK since January - the first targeted drug to gain EU approval in this therapy area.

But Scotland’s medicines watchdog has declined to give it the thumbs-up, thus limiting its take-up in public health. NICE is still considering what to do and expects to deliver a verdict next April.

A potential sticking point is that while a Phase III study showed this combination can halt the progression of the disease for up to six months compared to chemotherapy alone, it failed to show an increase in overall survival (OS).

Final OS data not expected until next year. However, this is a disease for which specific treatments have been thin on the ground. “Avastin offers an advance in the treatment of ovarian cancer,” insisted John Melville, general manager of Roche UK.

The manufacturer believes the SMC decision highlights a disparity in access to cancer drugs between patients north and south of the border.

“The majority of eligible patients in England already have access to it, at the clinically preferred dose, through the Cancer Drugs Fund. In Scotland, almost no patients have access,” he continued.

In fact, Avastin is the most-funded treatment on the government scheme, which injects an extra £200 million a year for new oncology medicines that have not been recommended by NICE.

Melville called on the government at Holyrood to act to prevent Scotland ‘falling behind’ England in access to cancer drugs that address an unmet medical need and benefit patients.

If the authorities do not, he concluded, it will even impact Scotland’s clinical research base and make it more difficult to recruit and retain the best doctors - a stark warning which reflects Roche’s disappointment.

Yet things are far from cut and dried for Avastin in England: even though it is Roche’s biggest-selling medicine, making more than $6 billion in annual sales, it has repeatedly been knocked back by NICE already.

Although indicated to treat metastatic colorectal cancer, breast cancer and renal cell carcinoma, it has not been recommended in any of them, which means Roche may be approaching NICE’s latest deliberations with trepidation.

The ABPI has already said it would like to see drugs such as Avastin assessed under the new Value-Based Pricing plans in order to allow it access to the UK market.   

Adam Hill

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