Three English cancer patients have said that they will go to court to obtain access to Velcade (bortezomib), Janssen-Cilag's treatment for multiple myeloma, if a National Institute for Health and Clinical Excellence final appraisal committee meeting on September 6 upholds the panel's earlier decision that the drug is not cost effective.

Late last month, doctors and patient groups condemned NICE preliminary guidance that stated Velcade should only be used in “well-designed clinical studies.” The International Myeloma Foundation said that the panel had not understood where Velcade is best used in the treatment pathway and described the recommendation for further clinical trials as “flawed and unethical,” given that Velcade is fully licensed, and not an experimental drug.

The three patients - Marie Morton, Jackie Pickles and Janice Wrigglesworth, all from Keighley in West Yorkshire - who have been dubbed The Velcade Three - have said that they will take their case to the European Court of Human Rights, if they need to.

Velcade is available in Northern Ireland, Scotland and Wales and throughout the rest of Europe. In June 2005, patient groups were angered by NICE's announcement of delays in its assessment of the drug, which they said would mean a recommendation for its use in multiple myeloma would not be likely until late 2007. However, following a public campaign, Health Secretary Patricia Hewitt announced on July 20 last year that the drug would receive an early referral to NICE.

Multiple myeloma represents around 2% of all cancer cases in the UK, with about 4,000 new diagnoses annually, and IMF UK's president Gareth Morgan, professor of haematology at the Royal Marsden Hospital, London, describes it as “the Cinderella of cancers - it doesn't receive anywhere near the same level of funding that other cancers do.” With Velcade, which is the first new treatment for this cancer in over 10 years, “the evidence suggests, both clinically and cost effectively, that Velcade is best used at first relapse - there is no other licensed treatment in this area - we absolutely need this drug approved,” said Prof Morgan. By Lynne Taylor

To read the NICE Appraisal Consultation document relating to the use of Velcade in multiple myeloma, visit: