NHS to negotiate with drugmakers to ensure "best value" for Cancer Drugs Fund

The UK Department of Health announced Thursday alongside an increase of funding for the Cancer Drugs Fund that the listed medicines will now be assessed for efficacy and cost effectiveness. The Department of Health noted that the NHS will "negotiate with the pharmaceutical industry on cost to ensure best value."

In addition, the Department of Health indicated that "expert clinicians will evaluate the listed drugs to ensure patients are offered the most effective drugs for their condition...whilst drugs which are the least clinically effective will not be routinely available to new patients." Peter Clark, chair of the Cancer Drugs Fund, remarked "to ensure patients continue to have access to the best innovative treatments now and in the future, we must re-evaluate some of the drugs on the list. This is absolutely the right thing to do for patients."

Simon Stevens, chief executive of NHS England, added "we want to ensure the drugs provide maximum benefits to patients and that the [Cancer Drugs Fund] incentivises responsible pricing by drug companies." The NHS will also work with the National Institute for Health and Care Excellence, researchers and charities to look at "the wider process" by which it makes commissioning decisions on new cancer drugs. Stevens has asked the Cancer Drugs Fund to draw up plans to apply similar cost-effectiveness rules to those used by NICE before medicines are approved for funding.

Roche's advanced breast cancer therapy Kadcyla (trastuzumab emtansine) is currently available through the Cancer Drugs Fund, but was recently rejected by NICE as unaffordable for routine use on the NHS, despite the company offering a discount for the product. The full list price of Kadcyla exceeds 90 000 pounds ($149 000) per patient annually, above the threshold of around 25 000 pounds ($41 400) that the NHS would pay for a drug with the therapy's benefit. Kadcyla has been shown to extend median overall survival by 5.8 months. The changes to the Cancer Drugs Fund are designed to shift cancer drug prices slightly closer into line with those norms.

The Cancer Drugs Fund, launched in 2010, has so far given 55 000 patients with cancer access to treatments, although it had an overspend of 32 million pounds ($53 million) in the last financial year. The Department of Health said that funding for the therapies will rise from 200 million pounds ($332 million) a year to 280 million pounds ($465 million) a year with the fund confirmed until March 2016.

Also on Thursday, the Department of Health noted that Astellas and Medivation's Xtandi (enzalutamide), for prostate cancer, and Celgene's Revlimid (lenalidomide), for a new group of patients with myelodysplastic syndrome, will be added to the Cancer Drugs Fund.

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