We are very disappointed (and confused!) by the Scottish Medicines Consortium’s (SMC) announcement yesterday that it will not be recommending nivolumab (Opdivo) for use within NHS Scotland as a treatment for advanced renal cell carcinoma after prior therapy in adults. This is despite nivolumab’s proven effectiveness at prolonging the life of kidney cancer patients compared to everolimus, and the survival data from the earlier phase I and II clinical trials, where about one third of patients are still alive after 4+ years.
The SMC gave the reason being that the pharmaceutical company’s justification of the cost of nivolumab in relation to its health benefits was not sufficient, and, in addition, the company did not present a sufficiently robust economic analysis to gain acceptance by SMC.
It is well known that a clinical response to cancer drugs is individual, and some patients respond better than others; we believe that clinicians need to have a choice of drugs to be able to effectively treat kidney cancer patients. The SMC’s decision leaves clinicians in Scotland with a very limited choice of drugs with which to treat their advanced kidney cancer patients, and is denying patients access to a new and innovative class of drug with proven long-term benefits in about one third of cases. This decision also has a profound effect on the way Scotland treats cancer patients, leaving people with kidney cancer at a significant disadvantage and more likely to die prematurely compared to England, the rest of Europe and America.
“Not only is today’s news deeply distressing for kidney cancer patients and their families, it demonstrates the current frustrating and fragmented approach to reviewing cancer medicines in the UK,” said Rose Woodward from the KCSN. “Despite the fact NICE has recently recognised the benefits of nivolumab for kidney cancer patients in England, the SMC is set to block access for kidney cancer patients in Scotland. An urgent review of this decision is needed and I sincerely hope everyone involved will work hard to reverse this decision and get this drug to the kidney cancer patients who need it.”
 
The SMC have told us that there are several options now available to the pharmaceutical company; we will, of course, keep you updated with any developments regarding the next steps that we can take to make nivolumab available to Scottish kidney cancer patients.
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