NICE chief says working with NHS on future of cancer drugs fund, threshold change unlikely

by Richard Staines
LONDON, Mar 3 (APM) - The chief executive of NICE has said he is pleased with progress in discussions over the future of the cancer drugs fund, which pays for some oncology medicines rejected by the cost effectiveness body.
In an interview with APM late on Monday following last week’s Economist Pharma Summit, Sir Andrew Dillon said NICE is playing a role in shaping the future of cancer drug funding in England.
This follows the decision by National Health Service England to introduce cost-effectiveness testing on the cancer drugs fund, which was originally intended to pay for cancer drugs rejected by NICE.
The changes at the beginning of this year saw funding removed for many drugs, although the amount of money available will go up to 340 million pounds (467 million euros) a year from April (APMHE 41078).
Dillon told APM: “NHS England is leading on a process that involves NICE, patients and the industry to look at a longer term, sustainable approach to adoption of cancer drugs, whether through the cancer drugs fund or something else. We are enthusiastic participants in those discussions."
Dillon gave no details about the proposals being discussed. But late last year, he told APM he opposed two rounds of cost-effectiveness assessment for cancer drugs, adding that NHS England eventually wants the two processes to be integrated (APMHE 40506).

Cancer drugs fund under scrutiny post-election

He suggested that funding arrangements for cancer drugs would likely come under scrutiny following May's general election.
The opposition Labour party has already pledged to create a cancer therapy fund, which would pay for innovative surgery and radiotherapy as well as drugs when the fund ends in 2016.
“The CDF is very much a government initiative. A new government would want to reflect on how the fund should be taken forward, or what system and in what form.”
The fund was launched in 2011 and originally provided 200 million pounds (275 million euros) a year in funding.


Dillon said NICE is also looking at ways to improve its cost-effectiveness assessments following the government’s failed attempt to introduce value-based pricing in 2013, and the following inconclusive consultation on a revised value-based assessment (VBA) process last year.
Both schemes were designed to include social costs of disease and the burden of illness on the patient, into drug pricing.
”We continue to evaluate where we are post the VBA consultation and are continuing to look at ways to improve it.”
However, he noted that like the cancer drugs fund, nothing is likely to change until after the general election.
“We have a new government coming, we don't know what view that government is going to take,” said Dillon.

Threshold set until 2018

When asked whether NICE could lower its threshold for cost-effectiveness, Dillon suggested this may be at odds with the government’s desire to promote use of novel medicines on the NHS.
Academics from the University of York last month suggested the threshold should be set at around 13,000 pounds (18,000 euros) per QALY gained, instead of NICE’s upper limit of up to 30,000 pounds (41,000 euros). (APMHE 41526)
Dillon told APM: “You have to consider if the threshold were lower down, what would happen.”
He pointed out that it is not NICE’s responsibility to set the threshold and noted that the existing threshold is written into the Pharmaceutical Price Regulation Scheme (PPRS), which is due to expire in 2018.
“There is a system wide conversation needed for the threshold to change and that threshold is set until 2018 under the PPRS,” said Dillon.



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