Charlie Cooper writes in The Independent (05/09/2015) on the shameful state of our healthcare when – NHS cuts to drugs fund means thousands of cancer patients in England will be denied life-extending treatments.
Thousands of cancer patients in England will no longer have access to a group of life-extending but highly expensive drugs, after the NHS announced new cuts to the controversial Cancer Drugs Fund.
23 different treatments for breast, bowel, prostate and other cancers will cease to be funded from November this year, as officials seek to control the runaway cost of the fund.
Among eight drugs “de-listed” altogether is breast cancer treatment Kadcyla, which can extend life by on average six months but costs a £90,000 per year for each patient.
Some drugs will remain accessible via the fund, but only for particular cancers or stages of cancer. For example, Avastin will remain available for ovarian and some other cancers, but will no longer be accessible for cervical, breast or bowel cancer.
All patients currently receiving the drugs will continue to do so, but from November no new patients will have access via the fund.
The Cancer Drugs Fund (CDF), which is only available to patients in England, was set up by the Coalition government in 2011 to pay for drugs that had already been rejected as too expensive by National Institute of Health and Care Excellence (NICE). The decision was widely viewed as a political response to the public backlash that occurred every time NICE rejected a new drug on the grounds of cost-effectiveness.
Initially set at £200m, annual funding has increased to £340m this year, but the fund, which has helped 72,000 patients, is set to overspend by £70m in 2015/16.
Cancer charities reacted with dismay to the latest cuts. NHS England had already de-listed 35 treatments in March this year. Baroness Delyth Morgan, chief executive at Breast Cancer Now, said it was “a dreadful day for breast cancer patients.”
“Kadcyla is a one-of-a-kind drug proven to extend life, and the fact is that because government, the NHS and the pharmaceutical industry have failed to agree realistic prices for new drugs, some women will die sooner,” she said.
“Despite many families relying on it, the CDF has unfortunately failed, and today’s delisting will further reduce the NHS’ ability to keep pace with Europe in the treatment of breast cancer.”
The fund is due to expire in March. NHS England said it would “shortly” be consulting with NICE on the establishment of a new “more systematic approach to getting the best price for cancer drugs”.
Simon Stevens, the chief executive of NHS England, hinted earlier this week at a new system in which NICE would have the power to approve certain drugs on a provisional basis in order to test their effectiveness in the NHS before making a final decision.
“We’re never going to be the country that pays the highest prices for things and nor should we aim to be,” he told delegates at an NHS conference in Manchester on 2 September. “What we want to do in respect of cancer drugs is to make sure we have, in addition to the usual NICE appraisal processes where NICE can say ‘yes’ or ‘no’, they can [also] say ‘maybe we should test this particular product further to find out if it’s good as we think it might be’.”
However, the Department of Health insisted that it was “absolutely committed” to the CDF.
Drug companies have also been critical of the fund. Alison Clough, acting chief executive officer of the Association of the British Pharmaceutical Industry said the cuts were “extremely disappointing” but criticised the fund as a “sticking plaster”.
“We believe that the de-listing process, which we recognise will be distressing for cancer patients, could have been avoided if NICE and NHS England had transitioned earlier to a more appropriate, sustainable solution for evaluating and approving cancer medicines for routine use,” she said.
Professor Peter Clark, oncologist and chair of the CDF, said: “There is no escaping the fact that we face a difficult set of choices, but it is our duty to ensure we get maximum value from every penny available on behalf of patients. We must ensure we invest in those treatments that offer the most benefit, based on rigorous evidence-based clinical analysis and an assessment of the cost of those treatments.”