Adverse side-effects highlighted

The National Institute for Health and Clinical Excellence (NICE) has not recommended a breast cancer drug for NHS funding.

Eribulin (marketed as Halaven by manufacturer Eisai) is prescribed to women whose breast cancer has spread within the breast or to other organs after they have received two sets of chemotherapy targeted at advanced forms of the disease.

Although the evidence indicates that the drug may help patients live for 2.7 months when compared to another drug, NICE said that it also caused “more undesirable” side effects than other treatments already available and that the effects on patients’ quality of life had not been assessed adequately. In order to qualify for assessment against NICE’s separate criteria designed for “end of life” treatments, a drug must extend life by three months, compared to current NHS treatment.

Earlier this month, NICE turned down another drug prescribed to this group of patients - women whose breast cancer has spread after receiving other treatments. However, the NHS already funds drugs for this group, including vinorelbine, capecitabine and gemcitabine. Doctors told NICE that, even if eribulin were approved by NICE, it would be unlikely to replace capecitabine and vinorelbine because of its related side effects.

These side effects include fatigue, alopecia, nausea and anaemia. Eribulin is estimated to cost more than £68,000 for every year of life gained.

Many private medical insurance providers would fund Eribulin, although some policies contain limits on the funding of cancer treatments. For example, CIGNA’s standard option for companies does not cover patients with secondary cancer. Aviva UK Health recently removed its limit on the funding of cancer drugs while Bupa has launched a new option for corporate clients – NHS Cancer Cover Plus – which will fund treatments not available on the NHS.