UK reprieve for three cancer drugs

Three cancer drugs that were supposed to be removed from the National Health Service on cost grounds have been granted a reprieve in a partial U-turn by health authorities.

The medicines were among 16 earmarked for ejection from the Cancer Drugs Fund — a special scheme to pay for high-priced cancer treatments — after a review found they were not sufficiently cost-effective.

Several manufacturers lodged appeals against the axing of their products and NHS England agreed to reconsider its decision on three of them, involving Eisai of Japan, Eli Lilly of the US and Bayer of Germany.

These companies’ drugs, eribulin for breast cancer, pemetrexed for non-small cell lung cancer and regorafenib for a type of gastrointestinal cancer, remain available until a ruling is made.

Because this did not happen before the government went into purdah on Monday — the pre-election period when civil servants are barred from making politically contentious decisions — the three drugs are likely to remain available until a new government is in place after the May 7 general election, according to people close to the situation.

This has been welcomed by patient groups and the three manufacturers, which stand to gain from at least two months’ extra sales beyond the March cut-off when funding was removed from the other axed medicines.

However, the companies have criticised the uncertainty over the drugs’ long-term availability and the protracted process has deepened the anger of those drugmakers whose appeals were rejected. These include Sanofi of France, which had its cabazitaxel medicine for prostate cancer and aflibercept for colorectal cancer dropped from the fund last month.

Tarja Stenvall, UK general manager for Sanofi, said the company remained “in dialogue” with NHS England over potential ways to restore access to cabazitaxel but warned it might seek a judicial review if a compromise was not reached. “We do not wish to take legal action. However, we may have no alternative,” she said.

Peter Clark, chairman of the drugs fund, said in January that an overhaul was essential because, without action, the cost of the fund would have more than doubled from £200m last year to £420m next year. This would have forced cuts in other forms of cancer care such as surgery and radiotherapy.

By dropping the least cost-effective medicines, the bill could be reduced by £80m. High quality global journalism requires investment.

However, drug makers have been fiercely critical of the review process, Pfizer said it was “deeply flawed” and NHS England accepted that Eisai, Eli Lilly and Bayer had grounds for their drugs to be reconsidered. High quality global journalism requires investment.
Gary Hendler, head of Eisai’s operations in Europe, said there would be no need for a special fund if more cancer treatments were approved by the National Institute for Health and Care Excellence, the NHS cost watchdog. High quality global journalism requires investment.  High quality global journalism requires investment.

A study commissioned by Johnson & Johnson, the US healthcare group, showed that 73 per cent of drugs reviewed by Nice between 2006 and 2014 were recommended for use in the NHS on a full or restricted basis but only 58 per cent of cancer medicines. This latter number has fallen to 48 per cent since 2010, when the Cancer Drugs Fund was launched. High quality global journalism requires investment.

Cancer drugs pose particularly difficult ethical and economic dilemmas because many have the potential to extend the lives of people with advanced forms of the disease by a few months, typically at a cost of tens of thousands of pounds.


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