The Northern Echo (KC) 18-May-08
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Criticism over NHS cancer drug rule
by Barry Nelson
KIDNEY cancer patients are being offered new hope thanks to a drug recently made available on the NHS, but liver cancer patients could be denied the same right.
Trials of the drug Sutent, which only became widely available on the NHS this year, show it extends the life of people with advanced kidney cancer by more than two years.
Last night, an expert said that the drug had brought a new era of treatment.
Yet at the same time, a hospital consultant has criticised a decision that could lead to liver cancer patients being denied access to a life-extending drug on the grounds of cost.
The Northern Echo’s End NHS Injustice campaign called for better access to cancer drugs for health service patients and has been credited with helping to bring about change.
Patients in the North-East were among the first in England to receive the drug after cancer specialists were allowed to prescribe it from July 2007.
But it was only in March that health watchdog Nice (National Institute for Health and Clinical Excellence) recommended it be made available across the NHS.
Results of recent clinical trials, published in today’s Journal of Clinical Oncology, found Sutent (also known as Sunitinid) far more effective than traditional treatment.
Until recently, most people with spreading kidney cancer were offered interferon alpha (IFN alpha), which has serious side effects and has been described as a medieval and toxic drug. The survival for Sutent patients given no further treatment after they stopped taking the drug was 28.1 months compared with 14.1 months for those on IFN alpha.
Professor John Wagstaff, from South Wales Cancer Institute, in Swansea, said: “This data heralds a new era in the treatment of metastatic kidney cancer in this country and throughout the world.
“With the dawn of new lifeextending treatment, such as Sunitinid, we are now able to give patients with this difficultto- treat cancer more hope.”
Rose Woodward, a former patient who leads the Kidney Cancer Support Network, said the results vindicated campaigners’ efforts.
She said: “There was a threeyear gap between Sutent being licensed in Europe and Nice getting their act together.
“This drug not only extends, but transforms the quality of kidney cancer patients’ lives.
“These results come as no surprise, but are vindication of everything we have said for two-and-a-half years, of all the letters and protests.
“The tragedy is that people have died; families’ lives have been ruined waiting.”
As one fight for access to drugs appeared victorious, a new fight was starting.
Nice has provisionally said that prescribing liver cancer drug Nexavar on the health service would not be cost effective, and will publish its final conclusion shortly.
Nexavar, which costs about £15,000 for a six-month course, is the only medicine licensed to treat the disease and can extend the lives of patients by about ten weeks.
Dr Helen Reeves, a consultant gastroenterologist at the Freeman Hospital, in Newcastle, said: “We would very much like to be able to prescribe this drug to our patients in the region.
“The actual numbers who would be suitable would be quite small, up to ten patients a year.”
Ironically, The Freeman was one of the UK centres that carried out clinical trials that confirmed the drug’s effectiveness.
Dr Reeves added: “With some cancers, patients probably have a long life ahead of them, but liver cancer patients probably only have a few months of life left.
“They don’t have the opportunity to go out campaigning.”
The consultant remains hopeful that negotiations with the drug manufacturer might reduce the price and persuade Nice to approve its use.
Imogen Shillito, of the British Liver Trust, said: “Denying patients with liver cancer an extra three months of life, purely on the grounds of cost, is a cruel and devastating blow.
“This treatment gives people a chance to have a few more precious weeks with their families and to die with dignity.”
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