Last week saw the rejection of another cancer drug by NICE, the body tasked with bringing new treatments into the NHS at an affordable price.
Draft guidance turned down use of enzalutamide – a prostate cancer drug – for use before chemotherapy, although it’s already available for patients later in the course of treatment once other options have been exhausted.
Unless the decision is reversed in the final guidance, that means that the only way NHS patients in England will be able to access the drug at this point in their care is via the Cancer Drugs Fund.
Our views on this decision were widely reported in the media. The guidance followed on quickly from another widely reported negative decision only a couple of weeks ago – this time rejecting olaparib, the first drug licensed to be targeted against an inherited cancer gene, for BRCA-mutated ovarian cancer. And it has drawn attention to what our Chief Executive Professor Paul Workman has called a ‘bottleneck’ for cancer drugs.
“There is clearly an important problem that needs to be addressed urgently in order to convert more of the pioneering cancer research we've seen in recent years into concrete benefits for NHS patients,” Professor Workman said. With widespread scientific and media interest in pioneering immunotherapy drugs over recent weeks, it’s an important time to be having this debate – which is only likely to intensify as more expensive treatments, like some of the immunotherapies, start to filter through to appraisal by NICE in the coming years.
Changing the system
Here at the ICR we’ve been calling for changes to how NICE evaluates new cancer drugs for some time – particularly to prioritise innovative drugs that could meet areas of unmet need in cancer treatment. You can read about some of the ways we think this can be achieved in these excellent blogs by Professor Workman, and by my colleague Dr Eva Sharpe, discussing the decisions about olaparib and abiraterone – also rejected last year in advanced prostate cancer before chemotherapy.
We believe that both NICE, and the pharmaceutical companies who market drugs, need to look at the approaches they are taking to making innovative new drugs available, if we are to widen the ‘bottleneck’ that is preventing these drugs from reaching the NHS. There are positive signs that some companies are willing to change, for instance by trying out new pricing structures – and Professor Workman recently met with NICE to present the case for some of the changes we think are needed to bring innovative new cancer drugs into the NHS.
The ICR discovered abiraterone, our science underpinned olaparib and we’ve also been involved in running clinical trials of enzalutamide. It’s frustrating for our researchers to see these drugs blocked – at least for some types of use – when there is strong evidence that they could be bringing benefits to people with cancer. We hope that regulators and companies can come together to address this issue, in order to make sure that new cancer drugs come through on to the NHS where they are needed, at an affordable cost.
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