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Options cut from cancer drugs fund list, despite surprise £60m boost

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NHS England has announced a surprise £60m boost to the cancer drugs fund, bringing it up to £340m for 2015-16, even as it slashes the number of drugs or indications available by 25.

Under the changes, eight drugs will cease to be available through the fund under any circumstances, while a further eight have had the range of their indications reduced (see below for details).

The unpopular changes were widely expected after NHS England began evaluating the cost effectiveness of medicines available through the fund last autumn in a bid to bring down its spiralling cost.

As a result of the review, 59 of the 84 most effective currently approved indications are to remain on the cancer drugs fund list, but with the addition of several new treatments, including panitumumab and ibrutinib.

However, it is understood that the announcement of extra money for the fund in 2015-16 has come as a surprise to the pharmaceutical industry.

The fund for the next financial year had originally been set at £280m, which was already a 70% increase since it was set up in 2010.

The further increase is likely to prove controversial, as it will reduce the funding available to spend on other conditions and types of care. Nursing Times’ sister title Health Service Journal understands the extra money will come from £14.6bn already allocated to specialised commissioning for 2015-16.

NHS England also said it was forecasting £80m of savings on the fund through negotiated price reductions for certain drugs and more effective treatments.

For example, Roche has reduced the price of its controversial breast cancer drug Kadcyla, which previously cost an average £90,000 per patient and has been found to extend life by six months compared to routinely funded treatments.

Under the changes, patients currently receiving a drug treatment through the fund will continue to receive that treatment, even if the drug is no longer in the fund.

Peter Clark, chair of the cancer drugs fund and a practising oncologist, said: “We have been through a robust, evidence based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound.”

 

New drugs or indications added to the fund’s list:

  • Panitumumab, a treatment for bowel cancer
  • Ibrutinib, a treatment for Mantle cell lymphoma
  • Ibrutinib for use in chronic lymphocytic leukaemia

 

Drugs or indications removed from the fund’s list

  1. Aflibercept – second line treatment of metastatic colorectal cancer
  2. Bendamustine – treatment of rituximab refractory low grade lymphoma
  3. Bevacizumab – first line treatment of advanced colorectal cancer with a single agent fluoropyramidine
  4. Bevacizumab – first line treatment of advanced colorectal cancer with combination chemotherapy
  5. Bevacizumab – second line treatment of advanced epithelial ovarian, fallopian tube or primary peritoneal cancer
  6. Bortezomib – treatment of relapsed/refractory mantle cell lymphoma
  7. Bortezomib – treatment of relapsed multiple myeloma
  8. Bortezomib – treatment of relapsed Waldenstrom’s Macroglobulinaemia
  9. Bosutinib – treatment of refractory blast crisis Chronic Myeloid Leukaemia
  10. Bosutinib – treatment of blast crisis Chronic Myeloid Leukaemia where there is intolerance of treatments
  11. Cabazitaxel – treatment of castrate-resistant Metastatic Prostate Cancer
  12. Cetuximab – second or third line treatment of metastatic colorectal cancer with combination chemotherapy
  13. Cetuximab – second or third line treatment of metastatic colorectal cancer with combination chemotherapy
  14. Dasatinib – treatment of lymphoid blast crisis chronic myeloid leukaemia
  15. Eribulin – treatment of advanced breast cancer
  16. Everolimus – treatment of advanced breast cancer
  17. Everolimus – treatment of well differentiated pancreatic neuroendocrine carcinomas
  18. Everolimus – treatment of metastatic renal cell carcinoma
  19. Lapatinib – treatment of advanced breast cancer
  20. Ofatumumab – treatment of chronic lymphocytic leukaemia
  21. Pazopanib – treatment of advanced non-adipocytic soft tissue sarcoma
  22. Pegylated Liposomal Doxorubicin – treatment of named sarcomas
  23. Pemetrexed – maintenance treatment of advanced non-squamous non-small cell lung cancer
  24. Pemetrexed – second line treatment of advanced non-squamous non-small cell lung cancer
  25. Regorafenib – reatment of adult patients with advanced gastro-intestinal stromal tumours (GIST) after failure of at least previous imatinib and sunitinib
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