AA Gill lung cancer: Life saving drug nivolumab writer denied now approved for NHS use

AA Gill died aged 62 last December after being diagnosed with what he proclaimed the 'full English' of cancers - lung cancer which has spread to his pancreas. 

AA Gill had chemotherapy on the NHS but could not access the immunotherapy drug nivolumab because it was not approved on the NHS.

Nivolumab, which has the brand name Opdivo and is manufactured by Bristol-Myers Squibb, should be made available to around 1,300 patients with lung cancer through the CDF, draft guidance from health watchdog NICE has said.

Bristol-Myers Squibb will fund the drug at a discounted price while more evidence is gathered to support it being widely used.

The company hopes that as more data comes to light about the drug’s effectiveness, Nivolumab will be made available to all patients with advanced lung cancer.

In new draft guidance, the National Institute for Health and Care Excellence (Nice) has approved the drug through the Cancer Drugs Fund while more evidence is gathered on its effectiveness.

Professor Carole Longson, director of the NICE centre for health technology evaluation, said: "This new deal means that we can give patients access to what we know is a promising treatment whilst more evidence is gathered on its value."

Last year NICE issued draft guidance which said nivolumab was not cost-effective for all patients with squamous and non-squamous advanced non-small cell lung cancer (NSCLC) - around 90 per cent of lung cancer cases.

But evidence presented by the drugs firm shows it is particularly effective in some patients.

Nivolumab blocks the ability of cancer to shield itself from the immune system.

It targets a protein on the surface of cells known as programmed cell death protein 1 (PD-1) receptor.

PD-1 reduces the activity of the body's immune cells when it binds to another protein called PD-L1.


Cancerous lung cells have more PD-L1 than normal cells, which stops the body from attacking the tumour.

Now, nivolumab will be available to some people with advanced disease whose tumours express PD-L1 if they have already been treated with chemotherapy.

Around 950 patients with squamous and 350 patients with non-squamous lung cancer are expected to receive treatment.

Professor Paul Workman, chief executive of the Institute of Cancer Research, London, said the decision was a step in the right direction.

"I'm pleased to see Nice and the drug's manufacturer showing flexibility in reaching agreement on the drug's approval.

"But this is another instance where patients in the UK have had to wait far longer than necessary to access an innovative new treatment.”

He said that initially, the drug was priced too high to ever have been judged cost-effective by the health watchdog.

“Companies need to come to the table with their best, most realistic price offer right at the start, so we get new exciting drugs, such as immunotherapies, to patients as quickly as possible.

"Immunotherapies are currently very expensive, but one of the ways to make them more cost-effective is to direct them to patients most likely to respond.”

In his last column, AA Gill said his doctor told his partner Nicola Formby: "If he had insurance, I'd put him on immunotherapy - specifically, nivolumab.

“As would every oncologist in the First World. But I can't do it on the National Health."

Gill wrote: "As yet, immunotherapy isn't a cure, it's a stretch more life, a considerable bit of life.

“More life with your kids, more life with your friends, more life holding hands, more life shared, more life spent on earth - but only if you can pay."


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