Patients in Wales with certain forms of colorectal cancer will now get restricted access to Merck’s Erbitux on the National Health Service. 

The All Wales Medicines Strategy Group has approved the drug as a potential first-line treatment for patients with epidermal growth factor receptor (EGFR)-expressing, metastatic colorectal cancer in combination with irinotecan-based chemotherapy or in combination with FOLFOX. 

Erbitux (cetuximab) will be available to those whose tumours are ‘RAS wild-type’, a particular genetic trait affecting around 50% of all metastatic tumours, but it is not recommended for use within NHS Wales as a single agent.

CRC is one of the most common type of cancer in Wales, with 2,272 cases in 2013, accounting for 12% of all cancer cases, and in around one quarter of cases the disease has already spread beyond the large bowel at diagnosis.

Welcoming the decision, Keir Woods, Business Unit Head of Oncology at Merck UK & Ireland, said: “It has always been our goal to bring patients in Wales in line with patients in England and Scotland who currently have access to this medicine in this setting”.

However, he also voiced concern over future access to Erbitux in this setting in England, as the drug is currently only available in the setting via the Cancer Drugs Fund, which is on the brink of a transformation. “We are committed to working with the NHS to ensure that RAS wild-type mCRC patients in England continue to have the same access to cetuximab as those in Scotland and Wales.”

Mark Flannagan, chief executive of the charity Beating Bowel Cancer, said the AWMSG’s decision “brings into stark contrast the uncertainty currently confronting English patients, who are facing the prospect of being denied access to such medicines that are routinely available elsewhere in the UK and Europe”. 

“In future English patients diagnosed with advanced bowel cancer in 2016 will receive a worse standard of care than those diagnosed in Wales,” he warned.