Charity groups and oncologists in the UK, plus the drugmakers concerned, say they are pleased that the country's National Institute for Health and Clinical Excellence has had a rethink over its ruling denying patients NHS access to two brain cancer drugs.
In a final appraisal document, NICE said it would recommend Schering-Plough's Temodal (temozolomide) for the treatment of newly-diagnosed glioblastoma multiforme (GBM) as well as Link Pharmaceutical's Gliadel Wafer (carmustine implant) in a subgroup of patients, overturning a decision it took in February 2006 saying that the two drugs were not cost-effective.
However, in September last year, the healthcare watchdog was forced to go back and resume its calculations after an error was found in its glioma cost-effectiveness model. On its website, NICE stressed the two drugs had been appraised independently rather than for sequential use, noting that temozolomide was recommended as an option for the treatment of newly-diagnosed GBM patients with a WHO performance status of 0 or 1. Carmustine implants are recommended as an option for the treatment of newly diagnosed high-grade glioma only for patients in whom 90% or more of the tumour has been resected.
S-P welcomed NICE’s change of heart as did Cancer Research UK, although the charity blasted the agency for taking so long to rethink its ruling. Its medical director, Professor John Toy said NICE's decision was ”very good news but added that it's completely unacceptable that NICE has taken well over two years to finally arrive at this decision."
He added that "research on temozolomide suggests that it improves the two-year survival rate for patients by 16%. We can't say how many lives have been cut shorter in the time it has taken NICE to approve [its] use." Temozolomide was developed by Cancer Research UK which took the drug into early Phase II studies after which S-P licensed the treatment, based on promising data in glioma and melanoma.