AVASTIN on NHS - Maintenance

[Hanksy]

Hello

Can anyone offer advice for funding of Avastin for maintenance purposes from NHS in England? My husband is receiving it now as first line treatment along with 5FU & Oxcilplatin. We are moving back to the UK following his 12th round and we were hoping that the UK could match the treatment that the US may offer. However after talking with the UK ONC Nurse she said their maintenance programme maybe a case of come back every 3 months for a scan!!! Im very alarmed by this as before chemo he was told he wouldn't last 6 months and now his prognosis is 'at best 2-3 yrs' so I dont want to shorten it by moving home to UK, although we have made steps and booked flights etc so it is all systems go!

The UK nurse did say that his age & the fact that he is receiving it now may help his case, but who knows.

Along with 16 other drugs, Avastin (chemical name: bevacizumab) will no longer be available as a first-line treatment for new NHS patients with advanced bowel cancer because it is judged too costly for the benefits it brings.

Any advice would be great.

[stu]

Hi,

If you contact beatingbowelcancer UK they will be able to advise you what the current criteria is and inform you how it is being accessed in the NHS. They have a help line manned by nurses. Or MacMillan may have current information as it is used in other treatment protocols also experiencing the same problem. They do use some other options as maintenance and you may want to explore them.
All the very best.
Stu

[Hanksy]

Thanks very much I will look into

[Alessandria]

Hi there, I don't know what the options are for maintenance chemo, but just to say that I am on Avastin in the UK as part of my chemo package and although I am receiving treatment through private healthcare I still have to pay for the Avastin as it's not approved for bowel cancer by NICE.

Good luck!

[Hanksy]

What's the cost's looking likely to be to fund Avastin?

[Alessandria]

Around £1000 each treatment

[LeonW]

Wow . .

[thehunter]

Hi there
Avastin is available if you live in Scotland on the NHS. I called Macmillan nurses about my brother and was told that we should move to Scotland where the Scottish Parliament has approved it. The NHS in England decided not to approve avastin. This is a crazy decision based on money.

[thehunter]

Googling it I think there may be restrictions on who gets it even in Scotland. Better check that it out but it's certainly worth looking into. Do you have private health care that will work in the uk? Aviva in the uk include it in their cancer package.

[Tim UK]

Do you have a UK lead oncologist yet? I understand that to some extent an onc is able to make a patient-specific case for the use of Avastin. As such one needs a doc who is both confident and established enough to make that call based on the case. For example BRAF-mutant KRAS-wild disease like mine was shown in a big Italian study to respond well to FOLFOXIRI plus bevacizumab as a first line:

(http://www.nejm.org/doi/full/10.1056/NEJMoa1403108)

Good luck.

[Hanksy]

Hi all

After my initial panicking I'm advised by my USA Onc that he will be done with Avastin after 12th round and that he could consider Folfori & Irinotecan for maintenance and I believe that is available in UK....

[wwroam]

I'm rather sceptical of the benefits of Avastin, so if it were discontinued I wouldn't be too down.
Also I wouldn't be too quick to discontinue Oxaliplatin. Talking to our Oncologist it is good for 20-24 cycles ( my partner did 22 before it ceased to be effective).
It was only then that she switched over to Folfiri ( Irinotecan + Fluorouracil) + Erbitux. Once you have switched you can't go back.
She has now done 6 cycles of Folfiri and is still going strong.

[stu]

Hi,
Yes, all the mainstream are available. I think Tim gave some really good advise on assessing which oncologist is best suited to your husbands needs. A proactive oncologist is essential plus it helps navigate the NHS, which I am grateful for but its a big system and it makes it so much easier when you have a good oncologist paving the way.
All the very best with the move.
Stu