British Health Service Cuts Access to Certain Cancer Drugs

The British National Health Service (NHS) announced yesterday that it will drop 16 cancer drugs from the list of treatments funded through its Cancer Drugs Fund (CDF).

Despite the CDF budget growing from £280 million to an estimated £340 million by April 2015, just 59 of 84 currently approved drug indications will be available through the fund this year. CDF leadership said the cuts were necessary to fund new treatments looming in the drug pipeline.

“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,” CDF Chair Peter Clark said in a press release.

“These are difficult decisions, but if we don’t prioritize the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”

New drugs that will be offered for the first time through the CDF include bowel cancer treatment panitumumab and chronic lymphocytic leukemia drug ibrutinib.

The cuts were enacted following a review by a national panel comprised of oncologists, pharmacists, and patient representatives who independently reviewed drug indications and new applications. The drugs were evaluated on clinical benefits, survival and quality of life, toxicity and safety, level of unmet need, and median cost of treatment per patient.

Drug manufacturers with treatments on track to be excluded from the CDF were given a chance to negotiate price reductions. An appeals process was also put in place for pharmaceutical companies to challenge the decision-making process.

The CDF said the cuts, along with negotiated price reductions and improved clinical effectiveness, would generate projected savings of approximately £80 million. Had the CDF drug list not been altered, the budget could have grown to approximately £420 million next year, which would have resulted in offsetting cuts in other areas, including radiotherapy, cancer diagnoses, cancer surgery, and vital services for other patient groups, according to the CDF.

In light of the cuts and the impact it could have on patient populations, the CDF said it will provide an added layer of protection to patients. These include continuing to offer a drug removed from the list to any patient who is currently receiving it through the CDF and maintaining the availability of any drugs that are the only therapy for a specific cancer type.

Additionally, if a drug for a particular indication is removed, some patients may be able to receive it in another line of therapy or obtain an alternative therapy. Exceptions may also be granted to physicians who apply for their patients to receive a drug removed from the list.

In the wake of the decision, the CDF was roundly criticized for its overspent budget by patient advocates and charitable foundations.

“Thousands of breast cancer patients have today been denied the chance of improved quality of life and extra time with their loved-ones. This news is devastating for them,” said Samia al Qadhi, chief executive of Breast Cancer Care, in a statement released yesterday. “However, we want breast cancer patients currently receiving these drugs to know they will still have access. The CDF is falling apart when there is still no long-term solution in place. While it is good that another three breast cancer drugs remain on the list and budget for the CDF will grow, the priority now must be to urgently find a sustainable system that works. Without this, cancer patients will continue to be denied access to vital treatment — they deserve better than this.”