Campaigners have reacted with disappointment after a drug to treat advanced kidney cancer was rejected for use on the NHS.
The National Institute for Health and Clinical Excellence (Nice) confirmed it was turning down everolimus (Afinitor) despite a new risk-sharing scheme proposed by manufacturer Novartis.
In the latest guidance, which Novartis plans to appeal, Nice said the drug does not give patients enough benefit to justify its cost.
Research suggests everolimus extends life by three months on average compared to current best standard of care.
But at £99 per day per patient, before any manufacturer discounts, it was judged too expensive by the watchdog.
Patients typically take the drug for 4.9 months, clinical trial data suggests.
Mike Hobday, head of policy at Macmillan Cancer Support, said the news was "frustrating", especially as advanced kidney cancer patients had already been denied four treatments (Avastin, Nexavar, Sutent for second line treatment and Torisel).
He added: "Everyone should get the clinically effective drugs their doctor recommends, regardless of what type of cancer they have. Yet people with rarer cancers aren't being given access to the treatments their doctors believe will improve the quality and length of their life.
"We believe that the Government's cancer drugs fund in England, established at £50 million this financial year and £200 million next year, will work towards addressing this issue.
"But Macmillan wants the Government to ensure that the new fund includes a focus on treatments for rarer cancers, so that the NHS will support patients whatever cancer they have. We want NHS support to be fair and equal."