A new drug that extends the lives of people suffering with liver cancer should not be available on the NHS, according to new guidance from the National Institute for Health and Clinical Excellence (NICE).
Sorafenib, also known as Nexavar, made by Bayer, has been shown to prolong the lives of people with an inoperable form of liver cancer.
France, Germany, Spain, Italy and Romania have already granted funding for the drug.
NICE is currently appraising the use of sorafenib for advanced hepatocellular carcinoma (HCC) in patients for whom surgery or therapies in the region the cancer arose have failed or are not suitable. NICE does not recommend sorafenib.
HCC is the most common type of primary liver cancer – a cancer that originates in the liver, not as the result of tumours spreading to the liver from other parts of the body. The only potentially curative treatment for HCC is surgery, but only a small proportion of patients will be eligible for this.
Andrew Dillon of NICE says, “We were disappointed not to have been able to recommend the use of sorafenib, but it does not provide enough benefit to patients to justify its high cost. The price being asked by Bayer is simply too high to justify using NHS money which could be spent on better value cancer treatments.”
Manufacturers Bayer will appeal the decision on the basis that making a decision purely on cost rather than clinical outcome contradicts the government's claimed strategy to bring cancer outcomes in line with European levels.
Professor Peter Johnson of Cancer Research UK says, "It is particularly frustrating that cancer patients in the UK are unable to access this drug when it is routinely available elsewhere in the world."
Liver disease, which is largely related to lifestyle factors, currently costs the NHS £460 million a year and kills over 3,000 people.
NICE has frequently been criticized for being cost conscious, when national bodies in other countries approve drugs purely on clinical and safety grounds.
NICE approval is important for PMI, as many insurers will not pay for treatment using drugs that do not have NICE approval.