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NICE reject kidney cancer drug

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A kidney cancer drug which treats patients with an advanced form of the disease has been rejected by NICE.

Everolimus, which is marketed as Afinitor by Novartis, is used for the second line treatment of advanced renal cell carcinoma.

In its final guidance, NICE said it was not recommending the drug for NHS-wide use as it “does not provide enough benefit to patients to justify its high cost”.

Every year around 4,000 people are diagnosed with advanced renal cell carcinoma, a kidney cancer which starts in cells lining the small tubes which help to make urine. The institute said that not all of these patients would be eligible for Everolimus.

NICE accepted, though, that while research evidence into the effect on survival times was not conclusive, “overall survival gain would be likely to be more than three months”.

NICE said: “It does not provide enough benefit to patients to justify its high cost, despite the discount offered by the manufacturer.”

Two other drugs, sunitinib and pazopanib, have previously been recommended by NICE for the first line treatment of advanced renal cell carcinoma.

NICE said Novartis Pharmaceuticals UK Ltd, which makes the drug, and the charity Kidney Cancer UK, both appealed against the latest decision but were rejected.

The manufacturer had agreed a patient access scheme with the Department of Health which would have meant Everolimus being available at around £34,235 per patient per year, or around £205,000 per patient for a full course of treatment, NICE said.

A revised patient access scheme was subsequently agreed with the Department of Health but the details of this have been kept confidential.

NICE stressed that doctors who feel Everolimus may work better in an individual patient than the available evidence suggests are able to apply for exceptional funding from their primary care trust or from the Cancer Drugs Fund.

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