The IMAGYN patient association calls on the government to reinstate Avastin on the “extra lists” of hospitals.
Avastin is probably the drug that has collected the most press articles. And for good reason: in 2012, no less than 500 studies were underway, including 16 clinical trials. The treatment in particular hit the headlines, when the authorities imposed on the laboratory a temporary marketing authorization for the treatment of AMD (age-related macular degeneration). The reason was then economical, Avastin costing 30 times less than the drug usually used, for a similar effectiveness.
This time he is back in the spotlight for cervical cancer. It is also about money and savings. In August 2016, the government decided to strike bevacizumab, a molecule marketed by Roche under the name Avastin, from the hospital “extra lists”.
Budgetary discipline
The “extra list” refers to a device put in place to reduce the budget of hospitals, which are unable to offer all patients the treatments available on the market at sometimes dizzying prices. The drugs on this list thus come out of the establishment’s budget and are fully covered by the State. In 2012, all sectors combined, the bill for this item amounted to 2.6 billion euros.
Strictly speaking, the authorities regularly revise this list in order to save money. In March 2016, a decree accelerated the pace of radiation. All molecules are assigned a “score” which measures the health and medico-economic benefits of a drug compared to its competitors. When this ASMR (Improvement of the Rendered Medical Service) is deemed insufficient, the molecule can now be removed from the list.
This was the case with bevacizumab. The drug’s effectiveness in breast cancer has long been debated, with some oncologists swearing by it, others showing skepticism. Studies do not show improvement in overall survival, but studies remain contradictory on improving quality of life.
“Death sentence”
The removal of Avastin from the “extra lists” causes anger and confusion among patients. The IMAGYN association, which brings together women with gynecological cancers, has published a plea to demand “the urgent return of bevacizumab in addition to the list”.
“As the summer lows approach, we are particularly concerned for these sick women and their loved ones. Patients who contact the association, sometimes desperate, looking for care solutions in a place of care delivering (still) the treatment, can we read in a press release from the association. We are helpless to answer them. Without therapeutic recourse, without hope, some of them will receive a rapid and final sentence: death ”.
Alternatives?
Avastin is used to treat persistent, relapsed or metastatic cervical cancer in combination with chemotherapy. According to the French National Authority for Health (HAS), “the efficacy / adverse effects ratio is average due to the tolerance profile, in particular gastrointestinal / vaginal fistulas (mainly rectovaginal)”, can we read in his opinion of july 2016. The HAS specifies that “there is a therapeutic alternative represented by the use of chemotherapy alone”, hence the ASMR score which was attributed to Avastin.
It prevents. According to the signatories of the plea, the molecule brings a considerable therapeutic benefit, by improving the quality of life of the patients but also the survival, even if moderate. “For many of these women, their relatives, this gain in life remains essential because it sometimes allows them to pursue a life project or simply to prepare for their” departure “by writing, for example, their advance directives”. The petition associated with the advocacy collected 9,200 signatures.
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