Roche’s Avastin Fails to Win NICE Backing for Ovarian Use

Roche Holding AG (ROG)’s anti-tumor drug Avastin failed for the second time in two months to win the backing of the U.K.’s health-cost regulator as a treatment for ovarian cancer in a draft decision issued today.

The National Institute for Health and Clinical Excellence recommended against the drug as an initial treatment for women with ovarian cancer that has spread beyond the ovarian lining and then returned six months or more after first being treated with platinum-based chemotherapy. The guidance also covers fallopian tube and primary peritoneal cancer, NICE said.

Though Avastin “may help to delay the spread of a patient’s cancer for a limited time,” there wasn’t evidence to show the drug’s benefit justified its cost, Andrew Dillon, NICE’s chief executive, said in the statement. National Health Service patients have other options for treatment, Dillon said.

Today’s recommendation comes after NICE refused on Dec. 18 to back Avastin for use after ovarian cancer has initially spread. Ovarian is one of the types of cancer Roche has said will drive sales growth for Avastin. The agency in December said it wasn’t clear whether the drug helped women live longer.

Roche said in a statement it’s disappointed with the NICE decision and will work with the agency to get a different recommendation for both categories of ovarian cancer. Avastin was the first drug in 15 years shown to improve the outcome for women with advanced ovarian cancer, the Basel, Switzerland-based company said.

Avastin had 5.76 billion Swiss francs ($6.32 billion) in sales last year, making it Roche’s third-biggest-selling drug.

Both NICE ovarian cancer recommendations are draft decisions subject to final review.

http://www.businessweek.com/news/2013-01-31/roche-s-avastin-fails-to-win-ni ce-backing-for-second-ovarian-use

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Maybe Roche will rethink the cost.

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I have just had a posting in the UK from someone at an OvCa charity -they have stressed this is a provisional decision and that discussions are ongoing.

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Cost Too Much is the concensus from the UK. Guess what folks, that what's going to happen here in the good old USA when the Affordable Care Act goes into full swing. The Cost of things will determine if its needed. Do I think Avastin at $11,000 is outragously expensive - Absolutely! But if its going to keep me alive - bring it on - that's why I pay insurance premiums.

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Not sure, trackgirl, but I don't think the Affordable Care Act will limit things just because of the cost. But personally, I think it's kinda strange to cut doctor's fees and not cut the prices we pay to drug companies. Doesn't make any sense.

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I agree that the insurance companies cut the cost of everything they pay except what they pay to the drug companies. When we were on Avastin the cost was almost $20,000 per dose which was paid in full yet the doctors and nurses and the facilities get paid a fraction of what they bill. Why is a dose so expensive? If they reduced the cost it might be helpful to so many.

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It's all about greed.L

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Why are drugs in so many other countries so much less expensive? Mexico, Canada, Turkey, even in the same exact packaging. I am sure the gov't and insurance companies could just say they are only paying X amount and the companies would take it. They don't get such high prices anywhere else.

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These costs aren't audited, so they may or may not be accurate, but it costs at least $500,000,000 to 1 billion to bring a new cancer drug through all the research and manufacturing. It takes about 10 years. No one would bother with investing that kind of time and money, with the uncertainty involved unless there was a lot of profit involved.
There are no non-profit drug manufacturers. Anywhere.
Prices are lower in Europe and Canada because their governments negotiate for lower prices and they have socialized medicine. They get the brand prices lower partly because they pay more for generics. Manufacturers here only make profits during the 10 years that a drug is protected by patents and make next to nothing on generic.

Our government could refuse to pay more than a certain amount, but the drugs companies could also decide to stop doing research, so these things have to be negotiated.

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One person's LIFETIME amount of premiums gets used up in one year of a drug like avastin. So unless there are a whole lot of people who are healthy their entire lives, the system is paying out more than its taking in.

Of course, I want MY life to be saved, but a government has to look at a very big picture, and decide whether the cost of a drug is worth an average benefit of a few months of life. If there are other drugs with nearly the same track record, they will make a choice.

That's one reason why volunteering in an organization like OCNA or NOCC is so important--we want to influence policy and raise money so ovarian cancer women get what they need and everyone else does too.

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carboplatin and taxol are no bargains. They are circa 1980s drugs. Combined with the overpriced Neulasta and it is costing nearly $40k per infusion. Seems horribly expensive for 30-year old technology.

That brings up the question of what is being done with the billions and billions collected by the various cancer groups - if the best we have is 30-year old technology? To me they are bureaucracies more concerned about their "organization" than delivering services.

The further down this path i go, the more disillusioned i become. Frankly, between the pharm companies, the mega-hospitals, and the insurance companies - i am siding with the insurance companies. Pharm is price gouging like big oil. The hospitals are accountable for nothing.

End of rant.

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My hospital where I get my Avastin is submitting $50,000.00 per infusion. Last year it was submitting $25,000.00. This is outrageous.

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Isn't it funny how the gubberment, including agencies like the DEA, the insurance companies, big pharm, etc. They are in the way of my relationship with my doctor, my care. I have paid for health insurance, as has my parents, & child. They tell us it is necessary for them to be involved because they are protecting us. We have been fed a bunch of hoo-ha and we have lapped it up, because we are trying to be good girls and do as we are told. Right?

Good Luck
Shannon

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It is also common knowledge, and legal, for oncologists to get a huge "kickback" each time they prescribe certain medications, avastin being one. Slight conflict of interest. One patient told me her oncologist was getting $10K each time he prescribed it.

I think the time for patents is 20 years, not ten. And with the drug companies making bigger profits than ever before, I, for one, don't buy the "they need the money for research" stuff. Sure, it costs money to get these drugs to market. Some of them. But they also do a lot of "me, too" drugs, i.e., they change the formula very slightly and get a new patent. I've seen it with ADHD drugs. When Dexadrine became very cheap, they produced Adderall (my patients tell me they don' t feel much of a difference). . When the patent for it ran out, they came out with Vivance. Each is only slightly different from the one before. doesn't take a whole lot of research to produce them.

You see it also with drugs for osteoporosis. First they come out with one that you take daily, and then one you take weekly, and then one you take monthly, and now they have one you take yearly. The drug is very similar, the delivery changes, and then they can get a new patent.

Drugs are much cheaper in Switzerland, subsidized by the government (or they've simply made it illegal for the companies to charge so much), but they do not have socialized medicine. Their system is much like ours, mostly private companies. I believe they do have a public option, however, unlike us. In any case, they simply don't allow the drug companies to gouge people, like we do.

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I am on Medicare and get avastin twice a month. The cost is about 20,000 per infusion, but MEDICARE does not pay the full cost. They pay a negotiated rate which is closer to 3,000. Still expensive, but not nearly as much.

I feel badly for the women in the UK who will not be able to get avastin, as studies have shown that in combo with taxol and carbo during frontline, it extends remission.

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How long does a drug patent last?
Answer:
20 years, but due to patents being filed before clinical trials have finished the average amount once on sale is around 8,9 or ten years. (marketing and advertising rights can last longer)

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As far as the bone density drugs, taking them once a year is a huge improvement over taking them once a day or even once a week. And after seeing every aunt, great aunt, and grandmother I had hunched over from collapsed vertebrae or moved into a nursing home because of a hip fracture, I think these are miracle drugs.

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I am not arguing for huge monopolies or price gouging or obscene prices. Of course not.

I feel very grateful that these drugs exist. I would have DIED within 6 months of my dx without an excellent surgeon and chemotherapy. I had cancer all over the inside of my belly--this wasn't going to go away with more spinach. These drugs are powerful enough to destroy cells that are growing OUT of CONTROL, and yet are selective enough to not destroy ME.

I'm angry I have cancer. Cancer sucks, and has turned my life and my family's lives, upside down. Cancer is the bad guy in the story. The drug companies, the doctors, the hospitals--all of them need improving but my rage is about the disease, not the system.

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I had to move from the NHS to private healthcare to get Avastin in the UK (luckily my hubby's plan covered me for Cancer) but I feel sad that it hasnt been approved for the NHS. I do understand that they have to measure the costs and only wish that they could move towards a combined care plan. I also feel that NICE should be honest that their reasons are to do with the costs rather than the outcomes.
The drug companies do spent hughly on the development of drugs but I think that there should be a tighter reign on the lenght of time they get that expenditure back and there is no excuse for increasing the prices or for giving kickbacks to prescribing centers, it happens all the time and is just so wrong.

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In line with what Argyl said in the beginning of her post about kickbacks. Oh ya!! For instance, my Avastin cost
$9,000 a treatment! And then I read about someone on the Dakota border who said that her Avastin was
$4,500 a treatment. It was enough for my husband to say that if I ever have to have it again, we will
"shop" it around. Don't need a brain surgeon to know it's the doctor's office's that mark it up!

It worked well for me and I've had all those extra months I might not have had- who knows?
I hate to think of being without it if I need it again.
Hearts

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HeartsToYou, interesting idea about 'shopping around.' This always confuses me when health care is provided through insurance companies. I guess with insurance you could still compare costs at different hospitals, but then as soon as you go out-of-network it's more expensive anyway.

There's a lot that upsets me about the Avastin arguments. The cost, of course, is outrageous, although as I've received this drug on a trial, the drug company has paid rather than me or my insurance. We have paid for the 3-monthly scans, doctor consultations etc, but we would expect to pay that if I were doing other treatments.

What really irritates me, though, is the argument that women only benefit from this drug for a few months. Personally I have benefitted from this drug for over two years now. I had barely 9 months remission after straight carbo/taxol, yet in combination with Avastin plus Avastin maintenance, I've had over two years remission. I realize this is probably more than average, and I also realize I can't yet talk about the overall survival benefit (which of course I may never know -- how will I ever know if a different drug taken at the same time would have been more or less beneficial?), but at times I do think the benefits of Avastin are underreported and get lost relative to financial considerations.

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