The National Institute for Health and Care Excellence has published interim guidance barring patients with advanced bowel cancer from routine NHS access to Merck Serono’s Erbitux and Amgen’s Vectibix, the only two personalised options still available for the disease.
The cost regulator for NHS treatments in England and Wales has ruled that neither drug would be a cost-effective use of resources as first-line treatment alongside chemotherapy for RAS wild-type metastatic colorectal cancer, in what UK charity Beating Bowel Cancer has called a “devastating decision”.
While recognising their clinical effectiveness, the Institute’s Expert Review group concluded that even if they were provided for free they would still not be cost-effective, as the methodology used takes into account all the associated treatment costs, including the partner chemo regimens and hospital expenses.
The decision means that both drugs will now only be available to NHS patients in England via the Cancer Drugs Fund, but this comes to an end in March next year, after which patients with metastatic bowel cancer will no longer be able to access a personalised therapy in the country.
“Treatment for advanced bowel cancer in this country will be going backwards, with patients diagnosed in 2016 facing worse care than patients diagnosed in 2015,” argued Mark Flannagan, chief executive of Beating Bowel Cancer, slamming the move. He called on NICE to reconsider its decision “before the UK slips behind the rest of Europe and the world”.
“We are disappointed with the preliminary NICE recommendation which in our opinion brings into question the methodology used to assess personalised medicines in patients with metastatic cancer,” added Elisabeth Prchla, General Manager, Merck in the UK and Ireland.
Both Erbitux and Vectibix had previously been rejected by NICE as second-line therapies for advanced bowel cancer in 2012, but their labelling was subsequently updated by European regulators to reflect their greatest efficacy in RAS wild-type forms of the disease, triggering a renewed technology appraisal in the first-line setting.