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Roche urges reform of Cancer Drugs Fund as NICE takes control

Published on 29/07/16 at 07:34am

Roche has warned that cancer patients in England are facing into an “uncertain future” as the new Cancer Drugs Fund (CDF) comes into effect today, July 29th 2016.

NHS England announced in February that the CDF would become a managed access fund within NICE (the National Institute for Health and Care Excellence). A parliamentary committee had found that the CDF had not been managed effectively by the Department of Health and NHS England, but many within the industry, including Novartis and Eisai, have criticised the reforms.

General manager of Roche UK, Richard Erwin, was critical of the revamped CDF and has called for urgent governmental reform to ensure patients can access the cancer drugs they need more effectively.

He says: “Now that the assessment of new cancer medicines for reimbursement has been returned to NICE, we must, as a matter of urgency, address the challenge they have in assessing the real clinical value of cancer treatments – which necessitated the creation of the original CDF in 2010.”

Erwin believes that the method that NICE will use in appraising new medicines for the fund will be inadequate and may harm patients. He continues: “Thirty-seven indications remain on the CDF and will be reviewed by NICE, but this unreformed appraisal system has previously rejected 10 of those for NHS use based on their cost-effectiveness. This could mean that thousands more cancer patients are denied medicines their doctors believe could be effective in their treatment.

“We are calling on government today to review NICE’s assessment methodology to stop patients facing ongoing anxiety around the availability of existing and new cancer medicines.”

In Roche’s case, Perjeta (pertuzumab) which is indicated as a neoadjuvant treatment of HER2 positive early breast cancer was provisionally turned down by NICE. At the time, NICE CEO Sir Andrew Dillon said: “In order to be able to recommend pertuzumab… the committee needed to have more evidence of its long-term clinical benefits, particularly its impact on overall survival.” Dillon also highlighted “uncertainties with the economic data” presented by Roche as a cause for concern.

At the time of its appraisal, NICE listed the total cost of treatment with Perjeta to range from £7,185 to £16,765.

In his statement, Erwin criticised NICE’s methodology as well as highlighting Roche’s commitment to provide cost savings on the drug. He adds: “NICE’s assessment criteria, which rely on survival data, make it unable to adequately appraise medicines in the neoadjuvant setting where survival data can take many years to mature.

“We have been waiting more than two years for a final decision on Perjeta… where again NICE’s methodology is unable to find combination treatments cost-effective, even when they significantly extend overall survival for late stage disease.

“These decisions highlight that the appraisal system is broken at both ends… We have offered more than £110 million in savings over the next four years on Perjeta and Kadcyla (trastuzumab emtansine) but NICE’s assessment criteria needs to be reformed to be able to accept these flexible pricing and assessment arrangements.”

With Roche just the latest in the pharma industry to issue strong criticisms of the new Cancer Drugs Fund, it is clear that industry could be set for a head-on collision with NICE in the near future unless all sides can find a method and system that works for all.

Sean Murray

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