NICE to rethink its ban on life-extending kidney cancer drugs

Great to have bureaucrats deciding whether you will live or die!

The NHS rationing watchdog could be forced into a humiliating U-turn over its ban on life-extending kidney cancer drugs within weeks, it emerged yesterday. The National Institute for Health and Clinical Excellence is expected to give the green light to at least two medicines previously rated as "too expensive" early in the New Year. The climb down will be a major victory for patients and cancer doctors and could extend the lives of up to 3,600 people with advanced kidney cancer.

Nice provoked a massive row in August when it unveiled plans to ban four drugs for advanced kidney cancer on the NHS - Sutent, Nexavar, Avastin and Torisel. Although the drugs are widely available in other countries including France, Germany, Spain, Mexico, Argentina and South Korea, Nice ruled that their cost - around 70,000 pounds a year per patient - made them too expensive for the NHS.

Cancer specialists say Sutent is the most important breakthrough in kidney cancer in the last three decades and can extend patient's lives by up to two years. They described Nice's previous decision to ban the drugs on cost grounds as "unfair and inhumane" and warned that patients would be condemned to an early death.

Yesterday Nice confirmed that it was looking again at the drugs in the light of new evidence about their effectiveness. A meeting in January will draw up new guidance on all four treatments. Nice is also under pressure to be more flexible in weighing up the cost effectiveness of drugs that don't cure patients - but which can give extend their life. A meeting in January will draw up new guidance on all four treatments. The final decision is likely to hinge on whether the price of one or more of the drugs can be reduced - or on drugs companies comping up with a "risk sharing" scheme in which they partly subsidise the final.

However there is growing optimism among senior cancer specialists and charities that at least two of the four drugs could get a reprieve. Pat Hanlon of the charity Kidney Cancer UK, said: "No decision has been made by Nice and we are still campaigning for the ban to be lifted, but we have reason to be hopeful."

Since Nice banned the drugs in August, research from America found that Sutent was more effective than previously thought. The reappraisal was also prompoted by a Government review into the way drugs for terminally ill patients are assessed by Nice. Under its current rules, Nice rarely approves drugs that cost more than 30,000 per patient per year even if they extend lives. The review will look at raising this figure - which many doctors claim has been plucked out of thin air. "These drugs are available all over the world and the UK is lagging behind other countries," said Mr Hanlon.

The drugs are expensive because advanced kidney cancer is not a common disease. That means the huge cost of researching and developing the drugs has to be covered by a relatively low level of sales. Over the last few weeks Pfizer and Roche, which make Sutent and Avastin, have been in talks with the Department of Health about the cost of the drugs. Pfizer is understood to have offered to cut its price by five per cent.

Nice said its appraisals committee was looking again at its draft guidance for kidney cancer drugs because new evidence had emerged - but that the decision had not been made. "We will publish a next draft within four weeks of the committee's meeting in January and issue final guidance in March 2009," a spokesman said.

Around 7,000 people are diagnosed with kidney cancer in Britain each year. The disease progresses to the advanced stage in around 1,700 cases annually. Around 3,600 patients in Britain would benefit from Sutent. Without the new drugs, patients are left with one other medicine on the NHS - Interferon. The drug does not work for all patients.

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