The UK’s drug evaluation and pricing system has been firmly back in the public eye in recent weeks, with acres of newsprint devoted to the latest cuts to the Cancer Drugs Fund.
As a research institution with a world-leading record in discovering and developing new cancer drugs, The Institute of Cancer Research often enters into the debate on drug pricing. That’s especially true when drugs we discovered, like abiraterone, and that were underpinned by our research, such as olaparib, are under review by regulators.
We often comment on these issues in the media – and in the ICR media office, I have the interesting job of working with our researchers and our policy team to send our messages out to journalists. Here are some of the main points we’ve been making to the media on cancer drug pricing:
The system needs reform
As our Chief Executive Professor Paul Workman wrote in an opinion piece for the Daily Telegraph recently, the whole system of drug evaluation, pricing, and development needs urgent reform to deliver more effective drugs, more quickly, for people with cancer. There is more detail on how to achieve this in Professor Workman’s own blogs here and here.
The key is innovation
Any reform to our drug evaluation system must focus on bringing innovative new drugs, which work in new ways, to people with cancer as effectively as possible. It’s the innovative drugs which will bring the greatest improvements for cancer patients and meet areas of unmet clinical need – and are most likely to tackle the major challenge of drug resistance in cancer treatment.
The Cancer Drugs Fund and NICE are duplicating work
The Cancer Drugs Fund was initially set up to pay for drugs which were too expensive to be approved by NICE or before NICE had chance to look at them. But the fund is overspent, and has now implemented two rounds of cuts which have included a judgement on the cost of treatments on the Cancer Drugs Fund list. This means that both bodies are now analysing the cost-effectiveness of cancer drugs and so inevitably there may be some duplication.
We’ve said before that drugs cannot command unlimited prices – and that generally NICE does a very good job in the unenviable positon of putting a cost on human life. The Cancer Drugs Fund, meanwhile, was intended to be a temporary measure, and we believe recent events underline the urgent need for a new unified system for evaluating treatments that can attract widespread support, and ensure that the most innovative and effective cancer drugs reach the patients who need them as fast as possible.
Approval can be the gateway to wider use
Often the decisions NICE and the Cancer Drugs Fund are being asked to make over new treatments are highly specific – should olaparib be made available for women with BRCA-mutant ovarian cancer, for instance.
These judgements can have crucial consequences, not only for the particular patient groups who are affected immediately, but also for much larger groups of people who could actually benefit from a treatment.
Approval of a drug is an important first step towards its wider use in new drug combinations, earlier in the course of treatment, and potentially in wider groups of patients with other cancer types.
Companies and regulators must work together
To improve access to cancer drugs, we need reform both from regulators who decide what the NHS will pay, and companies, which set the prices. We also need reform from governments, which need to better incentivise companies and non-profit organisations to discover and develop innovative treatments.
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