Cancer drugs may be cut after Cancer Drugs Fund review

Several drugs on NHS England’s (NHSE) Cancer Drugs Fund (CDF) list could be dropped following the review of its Standard Operating Procedure to include a value assessment component.

The change affects over 40 cancer drugs, including Kadcyla, Roche’s breast cancer treatment, and Avastin for breast and bowel cancer, which will now be reviewed to see if they are worth their high prices. Kadcyla, for example, is £90,000 per patient. Ten new drugs will also be considered under the revised criteria. Existing patients will continue to receive the drugs, however.

The CDF was originally set up in 2010 to meet patients’ demands for expensive cancer drugs, many of which were being rejected by health watchdog NICE on the basis that the benefits were not enough to justify the prices.

However, this ring-fenced money caused controversy among other patient groups who felt cancer was being given favourable treatment at their expense. The CDF also appeared to undermine the decisions of NICE and removed the incentive for pharma companies to reduce their prices to gain market access.

Despite extra funding secured for the next two years, the CDF has overspent and NHSE’s recent consultation with industry, NICE and patient groups reflected that all parties agree the fund, which was set up as a short-term solution, is unsustainable in its present form.

Commenting on the new value assessment component, Paul Catchpole, Association of the British Pharmaceutical Industry (ABPI) director of value and access, said: “We are very disappointed that NHSE did not address the concerns raised by the ABPI and pharmaceutical companies before finalising its proposals for how CDF medicines will be re-evaluated. Such a re-evaluation process would not be necessary in the first place if NICE quickly evolves the way it evaluates cancer medicines as part of more fundamental reforms. NICE itself recognised, in the recent Value Based Assessment consultation, that changes are needed and we would like to see this avenue being progressed urgently rather than putting an alternative and parallel process in place within NHS England.

“The proposed NHSE mechanism for evaluating medicines is crude and there is a risk that by evaluating cancer medicines in this manner important costs and benefits will be missed out of the process, potentially resulting at best in misleading conclusions being drawn and at worst NHS patients being denied access to CDF medicines, which do provide significant health benefit. The ABPI has made it clear that it could not support such an approach and that any further development of a value assessment process for CDF medicines should be undertaken by NICE. What we need now is a clear plan with a set of agreed timelines setting out how we will achieve this.

“The ABPI is committed to engaging in further dialogue with NHSE, NICE and other stakeholders to work on a sustainable and permanent solution to the CDF in a collaborative way which best meets the needs of the patients, the NHS and the pharmaceutical industry going forward. This should be based around the short-term evolution of NICE processes as the mechanism for undertaking value assessments for CDF medicines”

Charity Breakthrough Breast Cancer expressed concern that several effective drugs were to be reviewed and called on all political parties to find a long-term, UK-wide solution to the issue of access to life-extending drugs by the end of the next parliament.

Prostate Cancer UK also called for an overhaul of the drug assessment system to enable patients access to the drugs they need. Prostate cancer drug Jevtana is among those to be re-examined.

A national CDF panel, comprising patient representatives, doctors and pharmacists, will meet in mid-December to determine which drugs will remain on the list. Results will be published in the New Year.

Links

Cancer Drugs Fund budget increased – but pharma prices to be challenged

Political dynamite – England’s Cancer Drugs Fund

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