Roche and Genentech’s blockbuster cancer drug Avastin has been launched in the UK for the treatment of breast cancer, offering thousands of women a new weapon in the fight against the disease.
The drug, which works by cutting off the blood supply to tumours, was given the go ahead in March by European regulators for the first-line treatment of metastatic breast cancer in combination with the chemotherapy paclitaxel, after a clinical trial programme demonstrated “unprecedented disease-free survival,” according to the company.
In a Phase III trial (E2100) involving 722 patients, the group receiving Avastin (bevacizumab) and paclitaxel had a median progression-free survival of 13.3 months, compared to just 6.7 months for those taking paclitaxel alone. Overall, the combination slashed the risk of disease progression or death by 52%, Roche claims.
Roche has touted the drug as "the first and only anti-angiogenic agent which has been shown to consistently deliver improved overall and/or progression-free survival benefit for colorectal, lung, breast and renal cell cancer patients." But, despite its potential, Avastin’s success could be held back in the UK, as doctors fear that the National Health Service will not be able to afford the new generation of cancer drugs coming onto the market.
The cost-effectiveness hurdle
Responding to a recent BBC questionnaire, 180 oncology specialists said they were worried or very worried by the present situation, as many drugs are not being funded by the NHS because they fail to meet the cost-effective criteria set out by the National Institute for Health and Clinical Excellence.
And this is an obstacle that Avastin could soon face. A spokesman for Roche told PharmaTimes UK News that the drug has been recommended for cost-effectiveness analysis in breast cancer, but that the company has not yet been approached by NICE with regard to this.
But Roche may find it difficult to convince the Institute; with a price tag of £42,000 per patient per year, Avastin certainly doesn’t come cheap in comparison to other therapies on the market, and the spokesman confirmed that the group is currently “looking at ways of addressing affordability.”
Furthermore, a recent study, supported by an unrestricted educational grant from Roche, found that patient access to innovative cancer drugs in the UK pales in comparison to countries such as France and the US. The report, by Dr Nils Wilking, clinical oncologist at the Karolinska Institute in Stockholm, Sweden, and Dr Bengt Jönsson, director of the Centre for Health Economics at the Stockholm School of Economics, found that US uptake of Avastin for colorectal cancer was 10 times the average in Europe and, compared to the European average, was "very low" in Italy and the UK.
“We recognise that all emerging treatments are a challenge to the healthcare system and access to them is an issue,” the spokesman told PharmaTimes UK News. “But Avastin is an important breakthrough which has opened a new front in the treatment of breast cancer, and we hope it will be taken up by primary care trusts while they await a NICE recommendation,” he stressed.
