Times article on use of the Interim Cancer Drug Fund22 Dec. 2010
Only 200 patients helped by £50m fund for extra cancer drugs
Only a tiny proportion of the Government’s interim fund for cancer drugs has been claimed, almost a third of the way through its six-month lifespan, The Times has discovered.
The £50 million emergency fund for drugs not approved by the NHS watchdog has been used for only 200 patients, with doctors finding the application process bureaucratic and confusing.
Wide regional variations also emerge from figures obtained by The Times from regional strategic health authorities, with experts warning of a return to a “postcode lottery”. For example, while the NHS in the West Midlands has paid out £500,000 from the fund on 22 patients, in the South Central region only £38,000 has been spent on ten patients.
The fund allows doctors to pay for expensive cancer drugs that have not been deemed cost-effective by the National Institute for Health and Clinical Excellence.
Before the general election David Cameron promised a £200-million-a-year cancer drugs fund to allow these drugs to be prescribed on the NHS. The interim £50 million, which opened in October, will be available until the main fund begins in the spring. However, figures compiled from England’s ten NHS regions show that only about 200 people have been treated under the scheme nationwide, a tenth of independent projections, while in Yorkshire the number of applications is in single figures.
About £2 million, 4 per cent of the total, has been spent in the five regions which revealed spending figures. The remaining regions have had similar numbers of applications, suggesting that well under 10 per cent of the £50 million has been claimed.
Experts said that many doctors did not understand how to access the scheme, while others did not want to use it. A survey of hundreds of oncologists carried out by Professor Lesley Fallowfield of the Univeristy of Sussex said: “Many of the doctors had no idea what the policy of their trust was. Many doctors are still uncertain because it’s somewhat ambiguous as to what the process is.”
Different areas have the power to allow different drugs, with Avastin, a cancer drug rejected by Nice, automatically available under the fund in some parts of the country, but not in others.
Professor Fallowfield, a psychologist who studies how cancer is treated, said: “The process to access this fund is still unclear and my anxiety generally is that panels in different SHAs are making their own idiosyncratic decisions.”
She said there was a danger that those who “shout the loudest” could get treatment, not those who need it most.
Doctors also felt that they should put their responsibility to the wider NHS ahead of individual patients, the survey found, meaning that they often did not want to apply for unapproved drugs.
“Many doctors were thinking ‘I’m not sure that NICE hasn’t made the right call’,” Professor Fallowfield said.
A spokesman for the Department of Health said it was monitoring applications and would assess the fund in April.
COST AND EFFECT
Avastin (Bevacizumab) In advanced bowel cancer, can prolong life by six weeks on average, but NICE ruled £21,000 per patient was not cost effective.
Azacitidine In rare cancers of the blood and bone marrow, shown to extend life by nine months on average, but NICE provisionally ruled that £45,000 a head was too much.
Imatinib Used on chronic myeloid leukaemia and intestinal tumours, but NICE said there was not enough evidence to justify £19,500 per patient to give it to people whose tumours had been removed.
Temsirolimus (Torisel) Not approved for patients with kidney cancer.
Source: The Times – 22/11/2010