Avastin has been launched in the UK as a first-line treatment for renal cell carcinoma (RCC) to be used in combination with interferon.

The drug's first-line indication for RCC immediately gives it an edge over rival drugs Sutent, Nexavar and Torisel, which are only recommended for patients who no longer respond to interferon.

Avastin's manufacturer Roche has also undercut its rivals by pricing the drug at around a fifth less than its competitors.

Avastin will still be very costly at around £23,000 per patient per year, but seems likely to provide a cheaper option than its main rival Sutent when PCTs grant access to treatment.

But like its rivals, Avastin is awaiting NICE appraisal in RCC, and the competitors must all wait until January 2009 before the body finalises its review.

The Scottish Medicines Consortium (SMC) has already rejected Nexavar and competitor Sutent, said to cost £32,559 per patient per year.

In the UK, most PCTs do not fund either Sutent or Nexavar for treatment of RCC, only individual cases are submitted on exceptional grounds.

But the government says patients should not be refused innovative drugs solely because they have not yet been appraised by NICE.

The body has already rejected Avastin once before. Last January it declined to recommend Avastin's use on the NHS in its original colorectal cancer indication, citing the drug's high cost (£16,800 per patient per year) and limited extension of life.

pharmafocus@wiley.co.uk