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NICE system ‘slowing market access to cancer meds’

Two new reports show that UK access to new treatments and survival rates among lowest in Europe

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The delays and rejections associated with the current NICE appraisal system are both delaying and preventing patients from accessing new cancer medicines in the UK, where survival rates for cancer patients are among the worst in Europe, according to two new reports.

One of the studies, from the IMS Institute for Healthcare Informatics (IMS), examined the medicines appraisal system in 10 countries and found that a quality adjusted life-years (QALY) based system, such as that used by NICE in England, typically results in patients waiting longer for, and having access to, fewer new cancer drugs when compared with other countries using alternative approaches.

A further study by Abacus International looked specifically at the NICE system in England and reports that the number of cancer drugs approved by NICE since its inception decreased each year to 2013, with all new cancer drugs rejected by NICE that year.

The report also reveals that over the past decade NICE has been more likely to reject new treatments for cancer than for any other condition - with just 58% of cancer medicines approved compared with 85% for non-cancer treatments during this time.

The reports, launched in the British Parliament, were both commissioned by Janssen and aim to highlight its “serious concerns” over access to new cancer medicines in England. Janssen has a good record of gaining NICE recommendations, but last year a new indication for its prostate cancer drug Zytiga (abiraterone) was rejected by NICE. The appraisal has now been suspended, but the drug is still available via the Cancer Drugs Fund.

The reports also found that despite rejection of the majority of new cancer medicines, overall spending on cancer care across England and Wales remains similar to the European average.

But the country's average survival rates for cancer are among the lowest in Europe - 68% compared with 81% in Sweden.

The UK was also rated in the bottom two of the ten countries assessed for survival rates in breast, lung, kidney and prostate cancer.

Mark Hicken, managing director of Janssen, said: “As an industry leader in bringing innovative to patients who need them, Janssen is committed to working together with NICE, the Government, the NHS and patient groups to find a long term solution.”

NICE review

The King's Fund healthcare think-tank have now agreed to independently chair an expert panel consisting of a number of different stakeholders invested in the healthcare system including healthcare professionals, patient groups, professional bodies, politicians and health economists to look at the broader issue of access to medicines in the UK. Janssen says it will provide financial support for this process.

In partnership with Janssen, The King's Fund will shortly set out 'Terms of Reference' defining the scope of this review group.

Paul Burstow MP, a health minister for the government, told PMLiVE that political reform of NICE was a possibility, but would depend on the outcome of the review. A reform of NICE by the government, rather than by itself, has been a major policy the ABPI have been calling for over the past two years.

Burstow added that he would like too see better use of patient access schemes to go beyond “simple discounts and cuts” to more pragmatic ways of reducing costs to the NHS, whilst also speeding up the entire process, which he feels is too slow for patients.

Emma Greenwood, Cancer Research UK's head of policy, also told PMLiVE: “Evidence suggests that the UK is worse at getting newer cancer drugs to patients than similar countries, and these reports provide new insights into the effectiveness of the NICE process for cancer drugs. We want NICE to become more flexible in future, particularly as increasing numbers of targeted drugs come to market.

“We're working on how we move to a sustainable system for access to cancer drugs, which we hope will provide long-term solutions for cancer patients. Other work, such as the review led by the minister for life sciences, will look at how access to medicines across the drug development process can be improved.”

Article by
Ben Adams

16th March 2015

From: Research, Sales, Regulatory



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