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Cancer Commissioning—at a global and a local level: London Cancer New Drugs Group Annual Meeting
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Pan-London approach to prioritising new cancer drugs
Dr Monica Desai (Public Health Specialist Registrar, London School of Hygiene and Tropical Medicine) outlined details of a stop-gap measure designed to anticipate NICE decisions. The South-East London Cancer Network (SELCN) uses a scoring tool that takes into account the effectiveness of a new cancer drug as well as the strength of the associated clinical evidence.
Effectiveness criteria include magnitude of benefit and quality of life measured against alternative standard therapies and quality-adjusted life years (QALY). The strength of clinical evidence is ranked on the basis of good-quality, randomised clinical trials (RCTs), comparative phase II clinical trial data, non-comparative and unpublished data. Colour-coding is used to identify drugs to be funded once approved by the LCNDG, those that appear to meet NICE end-of-life criteria but which may have cost implications for PCTs, and those that should not be routinely funded.
Dr Desai reported that, on the basis of 50% uptake, the highest scoring drugs would cost the NHS nearly £127,000 per 100,000 of the general population, while those appearing to fit with end-of-life criteria would cost more than £308,000/100,000. Funding of new drugs for rare cancers would cost only £1,604/100,000. She emphasised that the vast majority of SELCN findings with respect to new cancer drugs were subsequently confirmed by NICE rulings.
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Discussion.