A kidney

NICE has been deliberating over whether to recommend drugs to treat kidney cancer

Six months after their preliminary decision, the National Institute of Health and Clinical Excellence (NICE) today issued its final guidance on the chemotherapy drug Sutent (sunitinib).

The drug will now be available on the NHS to treat patients with advanced kidney cancer.

We’re delighted with this decision.

Regular readers of this blog will remember our disappointment last August when NICE, which decides which drugs and treatments should be available on the NHS, decided initially not to recommend Sutent, along with three other drugs.

This led to an outcry as concerned patients expressed their frustration and anger – many on this blog. We listened to these concerns and fed them back to NICE as part of their consultation process.

Flexible pricing

NICE have reversed their stance in part because the manufacturers of the drug, Pfizer, have agreed to give the first round of treatment free on the NHS, making the treatment much more cost effective.

But even with this discount, the drug is still extremely expensive.

Amongst our recommendations to NICE we noted that we didn’t think their process was appropriate for all drugs, such as those used to treat patients with rarer cancers and those at the end of their life.

In January this year, NICE announced that they were changing the advice they gave to their committees to include more flexibility in these situations. This seems to have played a role in today’s decision, as the report states:

“Although it might be at the upper end of any plausible valuation of such benefits, in this case there was a significant step-change in treating a disease for which there is currently so little to offer patients”.

The decision will make an important difference to many patients with the disease. Sutent is a drug that brings clear benefits. Not only is it more effective than the current treatment (interferon immunotherapy), but – importantly when you are coping with a terminal illness – it has far fewer side-effects.

We hope that the next few years will see many more drugs like this being approved – drugs that have been rationally designed by building on our increasing understanding of basic cancer biology.

And it’s very gratifying to see NICE’s new attitude towards people with terminal illnesses or rare diseases bearing fruit so quickly.

Other three drugs not recommended

However, NICE also issued ‘preliminary’ guidance that three other drugs, Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus), would not be recommended to the NHS, neither as a first-choice treatment, nor to patients for whom Sutent wasn’t suitable, as there wasn’t enough evidence of clinical benefit compared to their high cost.

We hope that this decision will change as more clinical data become available, and, crucially, negotiations with the manufacturers over pricing schemes progress. The decision is open to consultation until 4th March.

We also hope that NICE will continue to turn their good intentions and new ways of working into practical decisions that benefit many more cancer patients, and that drug manufacturers follow the lead that Pfizer have shown in this instance.