Roche's Avastin rejected by UK's NICE in draft guidance due to 'uncertain evidence base;' Takeda's Mepact turned down on cost and efficacy

In a third rejection for the Swiss drug major Roche within a matter of weeks, the UK National Health service watchdog the National Institute for Health and Clinical Excellence (NICE), on Friday issued a negative draft guidance on the firm's Avastin (bevacizumab), not recommending it for use in combination with a taxane for patients whose breast cancer has spread to other parts of the body. The NICE also turned down Japanese drug major Takeda's Mepact (mifamurtide, L-MTP-PE) for the treatment of bone cancer in children, adolescents and young adults.

Last week saw the NICE say it could not recommend Roche's Herceptin (trastuzumab) for metastatic gastric cancer (The Pharma Letter July 7). The NICE also said last month that it has been unable to recommend the use of Roche's Tarceva (erlotinib) as a maintenance treatment for people with non-small cell lung cancer (NSCLC) who have had first line treatment and their disease had remained stable (TPL June 18).

In the current guidance, the agency said that evidence submitted by Roche did not show bevacizumab to significantly improve or extend the lives of breast cancer patients whose tumors have spread elsewhere in the body. This uncertain clinical benefit, combined with the amount of money the NHS is being asked to pay for the drug.