The cytotoxic drug paclitaxel (Taxol) is to be made available to all women in England and Wales with ovarian cancer following the long awaited ruling by the National Institute for Clinical Excellence (NICE).
Paclitaxel, in combination with platinum, should be the first line treatment after surgery in all cases of ovarian cancer and should also be used to treat women whose cancer has recurred or has failed to respond to other forms of treatment, according to NICE.
The recommendation is expected to cost the NHS an additional £7m ($11.2m) a year to treat the 1000 patients each year who have been denied paclitaxel because their health authorities have refused to pay the £7000 for a course of treatment.
An estimated 4000 women each year are suitable for the combination treatment, which extends the lives of patients by an average of 10-12 months, bringing the total cost of treatment to £28m. Three quarters of them have received it through the NHS, privately, or by taking part in clinical trials.
The charity CancerBACUP has called for extra cash to be made available to fund the drug and for health authorities to start funding treatment immediately.
“CancerBACUP will be seeking government reassurance that no further delays arise in patients getting the recommended treatments,” said its chief executive, Jean Mossman.
Kate Law, head of clinical programmes at the Cancer Research Campaign, commented that, although NICE's guidance on ovarian cancer would not bankrupt health authorities because of the relatively small numbers of women involved, the institute's imminent decision on the use of paclitaxel and docetaxel (Taxotere) for breast cancer would have far more serious financial implications.
“It is our understanding that whatever NICE recommends it has to be funded out of the existing budget. Taxol is really a test case. It is a well proven drug in ovarian cancer, and if health authorities can't find the money for it then they are going to run into problems when the verdict on the drugs for breast cancer, which affects 30000 women each year, is issued,” said Ms Law.
“The drug budget for cancer drugs is going to have to be increased if health authorities are to cope, especially in light of the fact that 10 more drugs for cancer are scheduled to be reviewed by NICE in the next year,” she added.
The institute's recommendation on paclitaxel and docetaxel for patients with breast cancer has been delayed after the manufacturer of Taxol (Bristol Myers Squibb) and CancerBACUP appealed against its ruling that only docetaxel would be approved for this patient group. The issue is now being reviewed again; a verdict is not expected before the end of June.
Copies of the full guidance are available on NICE's website (wwww.nice.org.uk) or by phoning 0541 555 455. 