As expected, cost regulators for National Health Service treatments in England recently barred patients with advanced pancreatic cancer from ‘routine’ access to Celgene’s Abraxane (nab-paclitaxel).

The National Institute for Health and Care Excellence has published draft guidance rejecting NHS funding for the drug in combination with gemcitabine for newly diagnosed and previously untreated patients on grounds that its cost “is not justified by its limited benefit” compared with existing treatments.

The development of new therapies for pancreatic cancer has been very limited in recent years, but while Abraxane is more effective than one of the treatment options currently available, the drug is associated with more side effects and is also more expensive, said NICE chief executive Sir Andrew Dillon.

The side effects include a drop in the number of blood cells causing an increased risk of infection, bleeding problems, tiredness and breathlessness, numbness or tingling in fingers and toes (peripheral neuropathy), gastrointestinal problems; aching joints and muscles, tiredness, feeling sick and hair loss, the Institute noted.

The most plausible cost per QALY for Abraxane plus gemcitabine compared with gemcitabine alone is likely to fall somewhere between £72,500 and the £78,500, and thus well outside of the realm of what is considered a cost-effective use of resources. Furthermore, the therapy also failed to meet the extension-to-life criterion when compared with FOLFIRINOX or gemcitabine plus capecitabine regimens.

Patients in England are still able to access the drug via the Cancer Drugs Fund. In Wales, patients are able to get treatment with Abraxane on the NHS following a recommendation by the All Wales Medicines Strategy Group, while the Scottish Medicines Consortium is currently considering its use for the first-line treatment of adult patients.