Roche’s Avastin is top requested medicine in UK’s cancer drugs fund

Roche's Avastin (bevacizumab) had the greatest number of applications for funding through the UK's cancer drugs fund from April 2011 to January 2012, according to national cancer director Sir Michael Richards.

Presenting the data at the National Cancer Action Team's (NCAT) network development programme (NDP) meeting in London last week, Sir Michael said Avastin had 1,975 requests for use during the first ten months of the fund, which provides £200m a year for local health authorities to purchase cancer drugs that have not been recommended by the UK's National Institute for Health and Clinical Excellence (NICE).

The Fund received a total of 8,557 applications across 122 indications for the period, with applications now coming in at a rate of 1,000 per month, according to Sir Michael.

After Avastin the second most requested drug was Merck KGaA's Erbitux (cetuximab), which had 1,029 applications.

Both drugs have been approved in the EU but Erbitux and Avastin recently failed to win NICE's backing for use after first-line chemotherapy in the treatment of metastatic colorectal cancer, with the Institute ruling the drugs were not a cost-effective use of NHS resources.

Under NICE's recommendations, Avastin is also unavailable for use in metastatic breast cancer on the NHS and Erbitux is not recommended for treatment of patients with recurrent and/or metastatic squamous cell cancer of the head and neck.

Sir Michael singled out Janssen's Zytiga (abirateron) for mention, saying it was “interesting in many ways” due to its “rapid uptake”, noting that it was the third most requested drug under the Fund, with 940 applications to date, despite only being approved in the EU in September 2011.

A final decision is still to be made by NICE regarding Zytiga's use in the NHS to treat prostate cancer, although draft guidance published in February, 2012 said its price tag was too high to justify its use.

Other drugs that received a high number of applications under the Cancer Drugs Fund included GSK's Tyverb (lapatinib), Roche's MabThera (rituximab) and Novartis' Afinitor (everolimus).

Regarding the outcome of each application, Sir Michael said he was looking forward to the start of the national chemotherapy audit, which aims to collect information on all patients taking chemotherapy in the UK.

Sir Michael said: “We do want to collect information on those patients chemotherapy through the cancer drugs fund and link that through the cancer registry data and see what the outcomes are for those patients.”

Regarding the current level of chemotherapy data knowledge in the NHS, Sir Michael said: “It is an embarrassment that after 12 years in my job I still do not know how many patients in the country get chemotherapy in a year. This will put that right.”

Oncology awards
Elsewhere at the NDP, QiC Excellence in Oncology was launched by NCAT's Stephen Parsons, and several guest speakers from the programme's supporters.

An evolution of Pfizer's Excellence in Oncology awards, it is the second programme in PMGroup's Quality in Care series that aims to recognise and share good healthcare practice and joint working in priority therapy areas across the UK.

QiC Excellence in Oncology is supported by several organisations from across industry, NHS and patients organisations, including Pfizer, Bristol-Myers Squibb, Novartis, Cancer 52, Macmillan Cancer Support, Thames Valley Cancer Network and NCAT itself.

Entry for the awards is now open, with submissions invited from NHS, industry and patient organisations across 12 categories covering the NHS Outcomes Frameworks, as well as individual and team awards.