A liver cancer drug that can extend the life of patients with severe liver cancer was deemed too expensive for use in England, Wales, and Northern Ireland by the National Institute for Health and Clinical Excellence. (NICE)
Make no mistake. The National Institute for Health and Clinical Excellence is a government entity that made the decision to NOT extend the lives of those patients with severe liver disease. The decision was NOT made by the patient but by a government panel instead. Those suffering with severe liver cancer were not allowed to choose and essentially told that their lives weren’t worth the cost of the drug. This is Government Healthcare.
The National Institute for Health and Clinical Excellence (NICE) said the cost of Nexavar – about £3,000 a month – was “simply too high”.
But Macmillan Cancer Support said the decision was “a scandal”.
More than 3,000 people are diagnosed with liver cancer every year in the UK and their prognosis is generally poor.
Only about 20% of patients are alive one year after diagnosis, dropping to just 5% after five years.
Campaigner Kate Spall, who won the right to have two months of treatment for her mother, Pamela Northcott, in 2007, said it had prolonged her life by four-and-a-half “precious” months.
It had allowed her 58-year-old mother, from Dyserth in Denbighshire, “closure” and “peace”, she told BBC Radio 4’s Today programme.
“The problem in Mum’s case is it took a year for me to fight for the treatment, so we’ll never know how well she could have done,” she said.
Prof Jonathan Waxman: “I’m very unhappy about the way these decisions are made”
“We had extra time, which was very precious to us all, her symptoms were helped greatly. And, more importantly, for Mum it was a case of getting some closure and peace.
“The psychological feeling when a group of people decide that you cannot have a treatment that can help you is really devastating.”
Cancer Research UK’s chief clinician Peter Johnson said the decision was “enormously frustrating” because there was no doubt about the drug’s effectiveness.
He said: “There’s no alternative treatment and there are no other places for people to go. It is expensive, but the only issue is cost and the number of patients affected are quite few – there’s probably only six or seven hundred patients a year.”
Nexavar – also known as sorafenib – had already been rejected in Scotland, despite studies showing it could extend the life of a liver cancer patient by up to six months.
The Scottish Medicines Consortium ruled that “the manufacturer’s justification of the treatment’s cost in relation to its benefit was not sufficient to gain acceptance”.
Andrew Dillon, chief executive of NICE, agreed: “The price being asked by [the manufacturer] Bayer is simply too high to justify using NHS money which could be spent on better value cancer treatments.”
And the group’s clinical and public health director, Peter Littlejohns, added the drug was considered “just too expensive” by its advisory committees.
‘NICE, on behalf of the the NHS, has to look at the cost-effectiveness of care.’
Nexavar is routinely offered to cancer patients elsewhere in the world, and Mike Hobday, head of campaigns at Macmillan Cancer Support, said he was “extremely disappointed” at NICE’s decision.
“It is a scandal that the only licensed drug proven to significantly prolong the lives of people with this devastating disease has been rejected, leaving them with no treatment options,” he said.
Alison Rogers, chief executive of the British Liver Trust, said: “The decision to reject a treatment for advanced liver cancer is a huge blow for patients. There has to be a point when the NHS says no. It’s sadly but simply unrealistic.
“This is a treatment to extend life for people where all other options have run out.
“It is particularly hard for people with liver cancer given that treatments for many other advanced cancers have been given the green light by NICE.
“People with liver disease often face stigma and discrimination and sadly this decision feels like a further disadvantage to them.”
Earlier this year, a government review of end-of-life treatment said NICE should give extra weight to drugs that could extend a patient’s life.
The Department of Health said NICE was not ignoring that recommendation, but the NHS could not just pay for any drug at any cost.