NICE gives the green light to bevacizumab for colorectal cancer
More than 7000 people in England will now be able to access to a life-extending treatment for advanced bowel cancer after NICE gave the drug bevacizumab the green light.
NICE has published final draft guidance recommending bevacizumab with chemotherapy for people with metastatic colorectal cancer. This is the first time NICE has been able to recommend bevacizumab for colorectal cancer, following the availability of lower-cost biosimilar versions of the medicine.
Around 35,000 people are diagnosed with colorectal cancer in England each year. Nearly 10,000 of those will have metastatic colorectal cancer, where the disease has spread to other parts of the body.
How the treatment works
Bevacizumab – also known by the brand name Avastin – is a targeted treatment that prevents tumors from growing. It is given as an infusion once every two or three weeks alongside chemotherapy.
Clinical trial evidence shows that when bevacizumab is added to chemotherapy, it extends the time before cancer progresses and increases overall survival compared with chemotherapy alone:
- People having bevacizumab plus chemotherapy lived without their cancer worsening for 9.4 months on average, compared to 8 months for those having chemotherapy only.
- Overall survival was 21.3 months compared to 19.9 months for chemotherapy alone.
The treatment is available as both a first and second-line option when targeted treatments or immunotherapy are unsuitable, offering a new choice for patients who would otherwise only receive chemotherapy.
New approach speeds up access
NICE previously could not recommend bevacizumab for colorectal cancer because the branded version of the medicine (Avastin) did not represent value for money for the NHS. However, the availability of more affordable biosimilar versions enabled NICE to conduct a new cost-effectiveness review.
This review was done under NICE’s Whole Lifecycle Approach to guidance development. The evaluation tested a simplified process to develop the recommendation. NICE’s whole lifecycle approach is a commitment in the Government’s 10-Year Health Plan to continuously review priority clinical pathways, ensuring patients receive the best possible care while the NHS spends wisely.
Helen Knight, director of medicines evaluation at NICE, said: “Assessing the cost-effectiveness of biosimilar medicines is an important step for NICE, allowing us to quickly get effective treatments to patients while ensuring the NHS gets the best value for money.
“Our Whole Lifecycle Approach means that in cases like this where more affordable versions of treatments become available, we can swiftly re-evaluate medicines that we previously couldn’t recommend. This benefits patients and an effective version of a drug being available at a lower cost is good news for the NHS.”
Mark Samuels, Chief Executive of Medicines UK, which represents off-patent generic and biosimilar medicine suppliers, said:
“I am delighted that NICE has recommended bevacizumab for advanced bowel cancer because it will help more patients to benefit from this life-extending treatment. I also welcome NICE’s use of a new value‑for‑money process that enables quicker decision-making, as demonstrated in this case. NICE has a vital role in reassessing treatments as more affordable off-patent biosimilar and generic medicines reshape how we evaluate costs and benefits. With many of the NHS’s most expensive medicines being biologics, biosimilars will play an increasingly important role in expanding patient access to proven therapies.”
Minister for Women’s Health and Mental Health, Baroness Merron, said:
“This is excellent news for the thousands of people living with advanced bowel cancer who will now have access to this life-extending treatment.
“The approval demonstrates our commitment to getting patients faster access to treatments and I’m pleased that NICE’s new Whole Lifecycle Approach is already delivering results.
“Our 10-Year Health Plan is about getting patients the best possible care, faster. This decision shows what that looks like in practice.”
The treatment is now available in the NHS.
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