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Audit to investigate decisions over kidney cancer drug prescribing in Wales

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The Welsh Assembly has ordered a clinical audit of NHS decisions over access to the kidney cancer drug sunitinib malate (Sutent).

Health minister for Wales Edwina Hart announced the audit of decisions by local health boards and NHS trusts following concerns at inconsistencies in the prescribing of Sutent.

A previous study found that in 2008 there were 73 requests for Sutent, with 23 patients having their treatment agreed, 48 having it rejected, with six now going to appeal.

All patients, for example, in Neath Port Talbot and Bridgend, who were recommended for the treatment by their consultants, received it, while in Cardiff of the 13 who were recommended, 12 were declined. In Swansea, none of the 14 patients recommended for Sutent received it, while in North Wales, of the seven requests, three were agreed.

Mrs Hart has now asked for clinical audit of all the cases to ensure that consistency is being applied when decisions on funding are being taken.

NICE and the All Wales Medicines Strategy Group have issued initial guidance which states that Sutent should not be funded on the NHS due to a lack of evidence on its clinical and cost effectiveness. This means that a decision on funding such treatment is down to boards after considering the evidence for individual patients.

NICE is currently reconsidering its advice on Sutent and is expected to issue firm guidance by mid-to-late January.

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