Campaigners have condemned a decision to turn down a bowel cancer drug for use on the NHS in England and Wales.
The health watchdog NICE says the cost of avastin - at about £21,000 per patient - does not justify its benefits.
It offers patients with advanced bowel cancer the chance of a few extra weeks or months of life.
Cancer charities hope the new cancer drug fund set up by the government will give greater access to the treatment.
Avastin, also known as bevacizumab, works by reducing the blood supply to a tumour, causing it to shrink or stop growing.
It is used in the US and across Europe, but patients in the UK have to buy the drug privately or appeal to their local health authority for funding.
It is estimated that around 6,500 patients a year in the UK could benefit from avastin.
The decision by the National Institute for Health and Clinical Excellence (NICE) to turn down the drug for use on the NHS is subject to further consultation and appeal.
NICE said avastin typically offered patients with advanced bowel cancer an extra six weeks of life, when added to chemotherapy drugs, according to clinical data. But campaigners dispute this figure, saying other studies suggest it can prolong life for much longer.
Sir Andrew Dillon, chief executive of NICE, said the body had recommended several other treatments for various stages of the cancer.
"We are disappointed not to be able to recommend bevacizumab as well, but we have to be confident that the benefits justify the considerable cost of this drug," he said.
Ian Beaumont, campaigns director of Bowel Cancer UK, said the charity was "disappointed" that NICE has turned down avastin for use on the NHS, when it was "so widely available to patients across the rest of Europe".
He said it was "regrettable" that it had taken NICE nearly a year to reach its verdict.
And he told BBC Breakfast the report NICE had partially based its decision on was "flawed" and that subsequent studies had showed better results which extended the life of patients beyond six weeks.
He added: "Obviously, at the moment there are massive pressures on the NHS because of the budgetary shortfalls.
"But I would argue that if people who are dying in agony are not a priority for the NHS, if people who can be helped to live longer and feel better in that situation are not a priority for the NHS, then there's something wrong with the priorities of the NHS."
Campaigners believe the new cancer drug fund set up by the coalition government could be a source of funding for patients seeking drugs like avastin.
Patients in England will be able to apply to the £50m interim cancer drug fund from October, with further money available next year.
Mike Hobday, head of policy at Macmillan Cancer Support, said the NICE decision was "devastating news" for patients with advanced bowel cancer.
"Although a few extra weeks or months might not sound much to some people, it can mean an awful lot to a family affected by cancer.
"Again this reiterates just how important it is that the government's cancer drug fund comes into place sooner rather than later. On behalf of people living with cancer, Macmillan will hold the government to their £200m commitment in order to ensure people with rarer cancers have fair access to clinically effective drugs."
Barbara Moss, from Worcester, who has advanced bowel cancer, says she is "living proof" that avastin works.
She added: "It seems immoral to me that, as a result of negative NICE decisions like this one, people's choice of living or dying depends on whether they can afford a drug, because it isn't available to them on the NHS."