UK Approval for Asbestos Cancer Drug
On July 9, 2007, the National Institute for Clinical Excellence (NICE) signalled it's intention to allow UK mesothelioma sufferers access to Alimta (pemetrexed disodium) on the National Health Service (NHS).1 This is a dramatic turnabout from the position taken just a few months ago by the NICE Appraisal Committee in its interim ruling against the continued use of Alimta:2
the Committee was not persuaded that the evidence provided a robust demonstration of both clinical and cost effectiveness of pemetrexed plus cisplatin in comparison to the other treatment regimens for MPM. The Committee, therefore, could not recommend pemetrexed disodium as a treatment option for malignant pleural mesothelioma.3
Although Alimta is not a cure for malignant pleural mesothelioma, clinical trials have shown it to be effective in prolonging life and alleviating distressing symptoms. It is the only licensed drug for treatment of mesothelioma within the NHS. Prior to today's announcement, people in many parts of the country were deprived of this chemotherapy; specialists believe that 700 people a year could benefit from this treatment. Welcoming the NICE decision, Chair of the Asbestos Victims Support Groups' Forum, Tony Whitston, said:
This excellent decision by NICE must now be swiftly acted on by primary care trusts (PCTs) throughout the country. Department of Health Guidance advises that every PCT 'should use its best endeavours to ensure that any new treatments recommended by NICE are available as soon as possible after NICE issues Technology Appraisal Guidance.'
TUC General Secretary Brendan Barber also urged PCTs to act immediately and said today's announcement was a victory for all those who campaigned for a change of heart from NICE. Dr. Harpal Kumar, Chief Executive of Cancer Research UK, supported the new position adopted by NICE saying Alimta is the only drug that can alleviate their (mesothelioma victims') suffering.
Explaining the U-turn, Dr. Gillian Leng, NICE implementation director and executive lead for the guidance, said:
Our initial review of the evidence available on pemetrexed disodium suggested that it was insufficient to demonstrate that the drug was better than other, far less costly medicines.
However, a number of significant factors have become apparent, which, taken together, have enabled the independent Appraisals Committee to recommend pemetrexed disodium as a treatment option of the majority of people with the cancer.
Although it is not mentioned by Leng, there can be little doubt that the intensive countrywide lobbying by asbestos victims, local support groups, trade unions, members of the medical professionals, politicians and health and safety campaigners will also have affected the final decision of the NHS watchdog.
July 9, 2007
2 Pemetrexed disodium (Alimta) is the first line of treatment for mesothelioma in the United States, Australia and many European countries; in December 2004, it became the UK's first licensed chemotherapy treatment for MPM, in combination with cisplatin. Despite NICE's interim guidance, Primary Care Trusts can, pending the final decision (Autumn 2007), still make Alimta available to NHS patients under the Health Service Circular 1999/176.