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NHS backtracks on Cancer Drugs Fund de-listings

Published on 12/03/15 at 10:56am
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NHS England is expected to perform a U-turn on several decisions to remove treatments from the cancer drugs fund when it publishes its latest CDF list today, Pharmafile has learned.

It has agreed to continue to provide Novartis’ Afinitor (everolimus) for two of the three indications for which it was due to be removed when an updated CDF list was published in January.

A Novartis spokesperson told Pharmafile the company had reached an agreement with NHS England to ensure continued access to Afinitor for women with advanced breast cancer and people with metastatic renal cell carcinoma.

But Novartis still feels the CDF process “lacks the robustness used by other UK cost-effectiveness bodies”. Afinitor is available for pancreatic neuroendocrine tumours (pNETs) in Scotland and in Wales, but has been ruled out for assessment as a treatment in this indication by NICE due to the rarity of the cancer.

“Novartis has worked with the CDF to reach an agreement for everolimus in advanced breast and kidney cancer to ensure that patients who could benefit will have continued access to everolimus through the CDF.

“While everolimus in these indications met the clinical threshold set by NHS England, it did not meet the new cost-per-patient threshold. Novartis could not find an agreement with the CDF for patients with well-differentiated pancreatic neuroendocrine tumours (pNETs) and as a matter of principle, has accepted delisting of everolimus in this indication rather than agreeing to a situation that significantly undervalues our medicine.”

Instead Novartis will supply Afinitor to patients with pNETs on a ‘named patient basis’, upon request from oncologists through their local clinical commissioning group (CCG).

Following a review of unaffordable treatments, NHS England originally announced it would drop 16 drugs in 25 indications from the list to create an estimated £80 million in savings.

The updated list is due to be published today, and will take effect in the NHS immediately. NHS England has agreed to further reconsiderations of some drugs when the National Cancer Drug Fund Panel meets on March 16, with final decisions due shortly after.

Other companies whose cancer drugs were removed from the list in January are awaiting the outcome of their appeals. Eisai’s Halaven (eribulin) was de-listed as a treatment for women with advanced breast cancer, and at the time of the decision Eisai president Gary Hendler spoke of his ‘outrage’ at NHS England’s ‘arbritary removal of drugs’ from the fund.

In a statement to Pharmafile, a spokesperson for Eisai confirmed the company had lodged an appeal with NHS England and have had their appeal upheld.

“Eisai appealed against the decision by NHS England to remove Halaven from the Cancer Drugs Fund on the basis that the evaluation process was rushed and inconsistent. In addition, the decision failed to recognise the clinical efficacy of eribulin, something that has been acknowledged by the hundreds of doctors who have ensured more than 2,000 women have already benefited from the life-extending treatment through the CDF since 2011.”

Lilly has also had its appeal against the decision to remove Alimta (pemetrexed) as a treatment for some patients with non-squamous non-small cell lung cancer upheld in part. 

In a statement the company says: "Lilly believes that the original decision to delist pemetrexed from the National Cancer Drugs Fund was a disservice to patients and was based on a flawed assessment of this medicine. Lilly hopes that the CDF Panel will positively reconsider their decision."

Lilian Anekwe

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