Don’t deny cancer sufferers this drug

Bevacizumab is the first new treatment for ovarian cancer in 15 years and in those at highest risk it can delay the progression of the disease by more than three months and improve survival by more than seven months, compared with chemotherapy alone.

Ovarian cancer is frequently diagnosed late, at an ­advanced stage, making successful treatment challenging. Approximately 300 women in Scotland could benefit from bevacizumab each year if they were able to access the drug through the NHS, as is the case south of the Border.

Bevacizumab is licensed at 15mg/kg, but evidence from the UK-led ICON7 trial has demonstrated that it is effective when used at half the dose (7.5mg/kg). However, in spite of this and calls from the clinical community, the SMC has stated it cannot recommend its use at 7.5mg/kg as it is outside the licensed indication. This is despite its own analysis showing the lower dose is cost effective. This demonstrates a fatal inflexibility in the SMC process needing urgent attention.

Clinicians in Scotland will only be able to prescribe ­bevacizumab through the IPTR (individual patient treatment request) process if they can demonstrate their patients are exceptional cases, which will rule out most women. Indeed, to date, no IPTRs for the first line use of bevacizumab have been granted by NHS Greater Glasgow and Clyde or by NHS Lothian. These boards cover around three quarters of the Scottish population. As such, at least 180 ovarian cancer patients have been disadvantaged by being unable to obtain bevacizumab in the ten months since it obtained its licence in this disease.

We urge you and the ­Scottish Government to act on calls from clinicians and patients to change the remit of the SMC so it can consider the use of this effective treatment at the preferred dose of clinicians (7.5mg/kg).

Louise Bayne
Ovacome

(Dr) Ros Glasspool

Consultant medical 
oncologist

Beatson West of Scotland Cancer Centre

(Prof) Charlie Gourley

Professor and honorary 
consultant, medical oncology

Edinburgh Cancer 
Research UK Centre

Annwen Jones

Target Ovarian Cancer (Dr) Melanie Mackean

Consultant in medical oncology, Edinburgh Cancer Centre, Western General Hospital, Edinburgh

Robert Marsh

The Eve Appeal

(Prof) Iain McNeish

Professor of Gynaecological Oncology, Institute of Cancer Sciences,
University of Glasgow, Beatson Institute for ­Cancer Research

(Dr) Fiona Nussey

Consultant in medical ­oncology, NHS Lothian NHS Trust

(Dr) Nicholas Reed

Consultant clinical oncologist and honorary professor of clinical oncology Gartnavel General Hospital

Gilda Witte

Ovarian Cancer Action

Yet again the postcode ­lottery strikes and the sufferers of serious illnesses such as women in Scotland are denied access to Avastin (the trade name of bevacizumab), a drug which can provide some relief to those with 
advanced stage ovarian 
cancer, and is available to patients in England.

Admittedly, differences in the provision of expensive drugs between Scotland and England exist across a range of drugs but this 
is cold comfort to those unfortunates who see patients south of the Border being treated better.

The Scottish Government is usually quick to praise the virtues of the health service in Scotland but this really masks those areas where ­inferior treatment is being provided.

Bob MacDougall

Kippen

Stirlingshire