LONDON, Jan 13 (APM) - Some 25 different cancer treatments will no longer be funded by the National Health Service in England, it has been announced.
NHS England has taken the decision after it emerged the 280 million pounds (358 million euros) Cancer Drugs Fund (CDF) will grow to an estimated 340 million pounds (435 million euros) from April 2015, it said in a late Monday statement. It was created in 2010 for expensive drugs not routinely available.
Some drugs have been removed completely, while others are being restricted depending on what type and how advanced the cancer is. Patients currently receiving the treatments will still be allowed to continue using them, it said.
The restrictions come into place from March 12 and affect a whole range of treatments for breast, pancreatic and bowel cancer.
The Rarer Cancers Foundation estimates it will impact more than 7,700 patients. The most commonly used treatment on the list is Roche's Avastin (bevacizumab), for advanced bowel cancer.
NHS England said the result of the review is that 59 of the 84 most effective currently approved indications of drugs will roll over into the CDF next year, "creating headroom for new drug indications that will be funded for the first time".
These are Amgen's Vectibix (panitumumab) for bowel cancer; Pharmacyclics/Janssen's Imbruvica (ibrutinib), for Mantle cell lymphoma and ibrutinib for use in chronic lymphocytic leukaemia (CLL).
NHS England said "difficult decisions" needed to be made. Even though the cuts will save 80 million pounds a year, the fund is still increasing to 340 million next year.
More than 60,000 patients have received drugs from the fund since it was created.
Fund chair professor Peter Clark said the review, carried out by doctors, pharmacists and patients' representatives, had prioritised the treatments with the "best clinical benefit" to get the most out of "every pound".
"There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those. There were others that offered some benefit but were costly and I am pleased that a number of pharmaceutical firms worked with us to make prices more affordable, saving millions of pounds that can now be reinvested in other treatments.
"These are difficult decisions, but if we don't prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline."
Avastin denied for ovarian, metastatic bowel cancers
Roche said in its own statement Avastin for first-line metastatic bowel cancer and second-line platinum-sensitive advanced ovarian cancer, will no longer be available on the CDF from March.
It said it welcomed the announcement from NHS England that patients can continue to access its breast cancer medicines Perjeta, Kadcyla and Avastin via the CDF, but is extremely disappointed that patients with advanced bowel and ovarian cancer will now be denied Avastin (bevacizumab) on the NHS, following their review of medicines available through the CDF.
Dr Jayson Dallas, general manager, Roche Products said: “We are pleased that we have been able to work collaboratively with NHS England to maintain access via the CDF to (Perjeta (pertuzumab) and Kadcyla (trastuzumab emtansine), at prices that reflect their clinical benefit.
"The review demonstrates that industry and NHS England can work together to make sure the very latest medicines are available to patients.
"Patients will still be able to access Avastin for a number of cancers but we are disappointed that, for the time being, the value of Avastin to advanced bowel and ovarian cancer patients has not been recognised; we do not agree with NHS England’s assessment and feel that critical evidence was not taken into account.”
List of drugs removed from CDF
Owen Sharp, chief executive of Prostate Cancer UK, said in its own statement: "Today's announcement is just another symptom of a drug appraisal system in meltdown."
Stephen Whitehead, of the Association of the British Pharmaceutical Industry, said in a statement issued late on Monday the move was "extremely disappointing and a significant blow to the health and wellbeing of future NHS patients".
"These medicines have been proven to be effective through clinical trials and have already provided benefit to thousands of NHS patients," he added.
“Whilst we are pleased that treatment for existing patients will be protected as a result of this decision and that some new medicines will be included in the CDF it does not detract from our longstanding belief that the CDF and this re-evaluation process was fundamentally flawed.
"The CDF remains a sticking plaster. The solution to this issue remains the urgent reform of NICE which will ensure that the right patients get the right medicines at the right time whatever their condition.”