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NHS drops 25 treatments from Cancer Drugs Fund

Published on 12/01/15 at 05:39pm
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Twenty-five cancer treatments will be removed from the Cancer Drugs Fund list, NHS England has announced.

Having concluded its review of which cancer treatments it can afford to continue funding, NHS England has published a new CDF list – and has removed 16 drugs in 25 indications from the list.

As Pharmafocus revealed last week NHS England has dropped Novartis’ Afinitor (everolimus), as well as Eisai’s Halaven (eribulin) and Sanofi’s Jevtana (cabazitaxel) and Zaltrap (aflibercept). Novartis and other companies are ‘exploring avenues for appeal’.

The NHS says removing the drugs from the list will create estimated savings of approximately £80 million “through a combination of negotiated price reductions and improved clinical effectiveness”.

The budget for the CDF will grow from £200 million in 2013/14, to £280 million in 2014/15, and an estimated £340 million from April 2015 – a total increase of 70% since August 2014.

The extra funding will create ‘headroom’ for NHS England to include two new drugs on the CDF list: Amgen’s Vectibix (panitumumab) for bowel cancer, and Janssen’s Imbruvica (ibrutinib) for Mantle cell lymphoma (a type of non-Hodgkin lymphoma) and chronic lymphocytic leukaemia.

Without the cuts NHS England says the Fund was projected to grow to around £420 million next year, “necessitating offsetting cuts in other aspects of cancer treatment such as radiotherapy, cancer diagnoses, cancer surgery, and other important NHS services for other patient groups”.

Professor Peter Clark, chair of the CDF, says: “We have been through a robust, evidence-based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound.

“These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”

He continues: “There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those. There were others that offered some benefit but were costly and I am pleased that a number of pharmaceutical firms worked with us to make prices more affordable, saving millions of pounds that can now be reinvested in other treatments.”

Earlier Astra Zeneca announced that it had decided to remove its ovarian cancer drug Lynparza (olaparib) from the list after being unable to reach an agreement with NHS England on the price of the drug.

Other companies received mixed news. Roche’s drugs Kadcyla (trastuzumab emtansine), Perjeta (pertuzumab), Erivedge (vismodegib) and Avastin (bevacizumab) all kept their place on the list, but Avastin was removed as a treatment for first-line metastatic bowel cancer and second-line platinum-sensitive advanced ovarian cancer.

Dr Jayson Dallas, Roche general manager, says: “We are pleased that we have been able to work collaboratively with NHS England. The review demonstrates that industry and NHS England can work together to make sure the very latest medicines are available to patients.”

But he continues: “However, we are now seeing the first casualties of a failure to reform the wider system of access for established cancer medicines, such as Avastin, which is being taken away from patients with some forms of cancer. 

The ABPI echoed these sentiments, saying it was "extremely disappointing and a significant blow to the health and wellbeing of future NHS patients."

Chief executive Stephen Whitehead says: "These medicines have been proven to be effective through clinical trials and have already provided benefit to thousands of NHS patients through their prior availability on the Cancer Drugs Fund.

“Whilst we are pleased that treatment for existing patients will be protected as a result of this decision and that some new medicines will be included in the CDF it does not detract from our longstanding belief that the CDF and this re-evaluation process was fundamentally flawed. The CDF remains a sticking plaster. The solution to this issue remains the urgent reform of NICE which will ensure that the right patients get the right medicines at the right time whatever their condition.”

Lilian Anekwe

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