In its latest draft guidance, NICE has been unable to recommend everolimus (Afinitor, Novartis) for the second line treatment of advanced renal cell carcinoma because it does not provide enough benefit to patients to justify its high cost.
The draft guidance is now with consultees, who have the opportunity to appeal against it. NICE has not yet issued final guidance to the NHS.
Commenting on the draft recommendations, Sir Andrew Dillon, Chief Executive at NICE said:“A diagnosis of renal cancer is devastating for patients and those who care for them and we are disappointed not to be able to recommend everolimus as a second line treatment option. However, we to have ensure that the money available to the NHS is used to best effect, particularly when NHS funds, like the rest of the public sector, is under considerable financial pressure.”
Notes to Editors
About the appraisal
1. Read more about this technology appraisal.
2. Renal cell carcinoma is a kidney cancer (tumour) that starts in cells lining the small tubes that help to make urine. In advanced disease, the tumour has spread inside the kidney, but may or may not have spread to nearby lymph glands. In metastatic renal cell carcinoma, the tumour has spread beyond the lymph glands to other parts of the body.
3. Evidence suggests that everolimus increased survival by more than 3 months compared with best supportive care.
4. The manufacturer of everolimus has agreed a patient access scheme with the Department of Health in which the first treatment pack of everolimus is free to the NHS and following treatment packs cost £2,822 (a 5% acquisition cost discount).
5. The number of people diagnosed with advanced RCC each year is less than 4000 and those eligible for everolimus (that is received first-line sunitinib and still fit enough to receive a second-line treatment) would be lower.
6. The committee felt that everolimus did fit the criteria to be considered under end of life. However, even with the patient access scheme incorporated, the additional weight that would need to be assigned to the QALY benefits would be too great to fall within the range currently considered a cost-effective use of NHS resources.
7. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
8. NICE produces guidance in three areas of health:
- public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
- health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS
- clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.
This page was last updated: 02 July 2010