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CDF chair: more treatment reviews to come

Published on 16/01/15 at 08:38am
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NHS England, Quarry House

The chair of NHS England’s cancer drugs fund has said there is likely to be more reviews of affordable treatments in future - and refused to rule out cutting more treatments from the fund.

Professor Peter Clark, a medical oncologist in Merseyside, said the current system for deciding which cancer treatments are available on the NHS is “broken - not logical, robust or rational”. 

As a result, it is likely that the treatments that are on the list will be reviewed again before the fund is set to end in 2016. 

His comments come just days after NHS England ‘de-listed’ 25 of the 84 treatments from the fund, a move that was heavily criticised by the industry and some cancer support groups. 

Clark said the NHS’ rising medicines bill for cancer - which currently stands at £1.45 billion, £390 million of which is for cancer drugs fund treatments - and the high costs of some cancer drugs, meant further reviews of the cancer drugs fund were ‘inevitable’.

“We’re in tough times. You and I have economic hardships, the government has economic hardships, and healthcare budgets are under pressure. We’ve got to maximise value – but yet, we see rising costs of cancer drugs. There are drugs in the cancer drugs fund that cost less than £10,000 a patient; while others cost more than £100,000 a patient.

“The pricing of some cancer drugs is not related to what we’re all experiencing. The NHS can’t afford everything in cancer, let alone other diseases, so what we’ve seen this week [cuts] has been inevitable.

“The cancer drugs fund budget has increased. But I suspect that until we’ve got everything into some kind of outlined process, then there will be a need for further re-prioritisation of what sits in the fund.”

Speaking at the Westminster Health Forum in London, Clark said the cancer drugs fund process had given pharma companies “a get out of jail free card” to avoid engaging with NICE.

“The cancer drugs fund has had many consequences. One of which has been to undermine NICE, and I regret that. The other thing has been that some pharmaceutical companies have had a ‘get out of jail free card’ for reimbursement. They don’t have to engage as constructively as they would do with a NICE technology appraisal process to get reimbursement for their drugs in the UK.”

There are meetings planned between pharma, NHS England, NICE and charities to renegotiate the process for evaluating cancer drugs fund treatments, and Professor Clark says he is hopeful that a ‘sustainable solution’ can be found.

He proposed significant reform of the cancer drug appraisal system, including gathering ‘real-life outcomes data’ on the treatments in the cancer drugs fund which is then fed back to NICE for re-appraisal. “I think that with this maturity of data there could be potentially a lot more NICE yeses,” Clark says.

This week a report by the National Audit Office shows that people with cancer in the UK have poorer access to medicines, and poorer health outcomes and survival rates than cancer patients in other European countries.

ABPI chief executive Stephen Whitehead says the report shows the cancer drugs fund “has proved nothing more than a sticking plaster”.

He adds: "The Cancer Drugs Fund was introduced as a temporary measure to enable the same level of access to medicines for patients as routinely available in the EU. As today's report points out, we have no evidence that it is working due to a lack of data from which to evaluate its performance.

"Now is the time to find a long-term, sustainable solution for evaluating the cost-effectiveness and efficacy of all medicines and we believe that the only solution remains the urgent reform of NICE.”

Lilian Anekwe

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