Afinitor too costly for NICE

 NICE has decided not to recommend Novartis’ Afinitor (everolimus) for NHS-wide second-line treatment of advanced renal cell carcinoma (RCC).

The Institute said that the treatment does not provide enough benefit to patients to justify its high cost, despite a Patient Access Scheme (PAS) being agreed with the DH.

Sir Andrew Dillon, NICE Chief Executive, says that the Institute has to ensure that money available to the NHS to treat cancer is “used to best effect”, although NICE does “regret” not being able to recommend Afinitor.

Doctors who feel that everolimus may work better in individual patients can apply for exception funding from their local PCT or from the Cancer Drugs Fund.

The PAS agreed with the DH provided the first treatment pack of Afinitor free of charge to the NHS and the following pack at a 5% acquisition cost discount.

NICE’s independent Appraisal Committee felt that cancer treatment did fit the criteria to be considered under end of life. However, when calculating the value of the Incremental Cost Effectiveness Ratios (ICERs) and the uncertainty around the ICERs, it concluded that it could not recommend Afinitor as a cost-effective use of NHS resources.

Novartis and Kidney Cancer UK both appealed against NICE’s final draft guidance on 28 February 2011, but both queries were dismissed on all counts.

NICE has previously recommended Sutent (sunitinib) and Votrient (pazopanib) for the first-line treatment of advanced RCC.