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Are changes to cancer medicine policy on the horizon?


Talks are underway on issues affecting access to cancer medicines in the UK, and The Institute of Cancer Research is at the discussion table.

Posted on 22 January, 2016 by Brad Gellert

My last blog expressed the ICR’s disappointment that the Off-patent Drugs Bill 2015-16 did not make it through Parliament. We believed this piece of legislation would have enabled better access to repurposed drugs in new disease areas, and joined the campaign to support it.

While this particular avenue has come to a close, the ICR has since been actively involved in a number of conversations on how to make innovative and effective drugs available to cancer patients.

Seeking ways to move forward in improving access to repurposed drugs, the ICR was pleased to participate in a discussion with the Minister for Life Sciences, George Freeman MP, along with a number of other stakeholders at the Department of Health. The talks were constructive, focussing on the barriers that prevent drugs like tamoxifen and bisphosphonates being prescribed widely in new indications.

We are hopeful that this meeting – along with a number of ongoing discussions – signals more broadly that positive changes are underway in the complex medicines landscape in the UK.

Also in late 2015, I attended the Britain Against Cancer conference where much of the discussion focussed on how to improve cancer survival rates in the UK, which lag behind those in Europe.

We heard from policymakers, clinicians and patients, and there was focus on improving early diagnosis through structural health system reform, better utilisation of registry data and a patient-centred approach. However, we also heard that alongside better prevention and earlier diagnosis, improving patient access to the most effective and innovative cancer drugs must be a priority in the fight to improve cancer outcomes.

One particular debate raised very interesting questions about the current state of play for cancer drug access and funding in the UK. Everyone agreed there is a need to have a public organisation that ensures the treatments the NHS funds are good value for money for patients and the taxpayer. However, the current system means that patients are missing out on some of the most innovative and promising treatments due to a bottleneck in approvals by NICE, in a system that is not unified across Britain.

Late last year, NICE did not recommend two innovative, effective but expensive drugs – abiraterone and nivolumab – because they did not constitute value for money, and called for public consultation. During this time patients are deprived of treatments while the stand-off between NICE and pharmaceutical companies drags on.

Recent proposed changes to the Cancer Drugs Fund (CDF) have come as a sign of a more sustainable and equitable mechanism that allows earlier access to promising and innovative treatments while ongoing data collection irons out uncertainty.

The ICR will respond to the CDF consultation arguing that promoting innovative drugs needs to be a central consideration in decision-making.

As ICR Chief Executive Paul Workman has long argued, and recently blogged about, a flexible approach is required between NICE and stakeholders to ensure new drugs are affordable. We believe less rigidity in considering different levels of evidence, smaller and more targeted trial populations, as well as a pricing mechanism that responds to evidence will help improve earlier access to those most likely to see their benefit.

The CDF consultation is a great opportunity to make vital changes to a flawed system.

While these conversations are underway, the ICR will continue to be present at the table, urging that the most innovative cancer drugs need to be available for those who need them.


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