All but one Cancer Drug Fund appeals rejected

Cancer

Of the four companies that appealed the removal of their drugs from the UK's Cancer Drugs Fund, only Bayer successfully overturned the decision.

NHS England has agreed to restore Bayer's stomach cancer drug Stivarga (regorafenib) to the CDF, but would not be swayed on its decision to de-list Eisai's breast cancer drug Halaven (eribulin), Eli Lilly's Alimta (pemetrexed) for lung cancer and Roche's Avastin (bevacizumab), used in multiple cancer types.

The £280 million fund is designed to provide emergency access to drugs not deemed cost-effective by the National Institute for Health and Care Excellence (NICE), but was overspent by around £100 million in 2014-15, prompting the removal of 16 medicines across 25 indications from the CDF list.

The cuts came after a review of each drug's safety and efficacy by an independent panel, which also handled the latest round of appeals, and amid growing speculation that additional de-listings will take place to staunch the funding haemorrhage.

Responding to the news, the Association of the British Pharmaceutical Industry (ABPI) said the CDF remains a "sticking plaster to cover a seeping wound."

The organisation's director of value and access, Paul Catchpole, said it was disappointing that a number of cancer medicines previously available to patients will no longer be accessible to newly-diagnosed patients.

"The ABPI believes that the CDF re-evaluation process is fundamentally flawed," he said, calling for "a holistic and joined up system encompassing both NHS England and NICE in order to transform the way that these medicines are evaluated and commissioned."

The future of the CDF hangs in the balance, with as yet no news from the government on the likelihood of it being continued when the current funding round comes to an end next April.

With nothing in place to replace it observers believe the CDF funding will be renewed, although industry would like to see a more permanent solution in place to remove uncertainty.

"What is needed is a clear plan with agreed timelines setting out how a sustainable solution will be achieved," said Catchpole.

Treatment targets being missed

The decision comes as Cancer Research UK has claimed that the NHS in England is missing a key target in cancer - making sure 85 percent of patients suspected of cancer start treatment within 62 days of a treatment referral.

In the last 12 months the rate has been at just over 83 percent and looks to be declining, says the charity, which points out that early diagnosis and treatment are vital for patients to have the best chance of recovering from cancer.

While treatment for breast cancer is above the target, for lung, lower gastrointestinal and urological cancers the rates are now between 73 and 78 per cent, well shy of the target and affecting "thousands" of patients.

The recent CONCORD-2 study by cancer charity Macmillan Cancer Support showed that cancer survival rates in the UK are lagging far behind those of other European countries.

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Andrew McConaghie

26 May, 2015