NICE says Roche's Avastin in breast cancer does not provide enough benefit to justify its cost

The latest and final guidance from the UK’s drug watchdog the National Institute for Health and Clinical Excellence (NICE) does not recommend Swiss drug major Roche’s (ROG: SIX) Avastin (bevacizumab) treatment (when used in combination with the chemotherapy drug, capecitabine) for the first-line treatment of metastatic breast cancer in people for whom treatment with other chemotherapy options including taxanes or anthracyclines is not considered appropriate.

This recommendation, which follows a negative final draft guidance last month (The Pharma Letter July 6) has remained constant throughout the process of guidance development (which includes a thorough review of all available evidence and a public consultation) with no objections to the recommendation being raised by the manufacturer or other consultees at any stage, the NICE stated.

Sir Andrew Dillon, NICE chief executive, commented: “We can’t recommend a drug that has not been shown to work as well as, or better than, current treatments and costs much more. Evidence presented to the independent Appraisal Committee did not conclusively show that bevacizumab, in combination with capecitabine, could improve overall survival or improve a patient’s quality of life more than current treatment. These uncertainties combined with the high cost of bevacizumab mean the drug simply isn’t cost-effective.”