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December 2011
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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 contd.
Dr Desai said that although uptake of the scoring system had not been uniform across the region, it had resulted in a 25% decrease overall in the number of independent funding reviews (IFRs). She emphasised, however, that such a scheme is not designed to allow PCTs to pick and choose which drugs to approve or disallow—they are expected to accept the package as a whole.
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Dr Andy Mitchell (Medical Director, NHS London) reported that £1 billion is being wasted in London as a direct result of non-compliance with prescribed medication. In turn, this has significant safety implications—6.5% of hospital admissions are related to adverse events, and 9% of incidents are drug-related.
He said that the principal objective of the London New Medicines and Treatment Project (LNMTP) was to improve efficiency by developing collaborative processes for the approval of new drugs, thereby supporting PCTs in their constitutional obligation to give patients the right to:
- Drugs that have been recommended by NICE
- Rational local decisions about other drugs based on a proper consideration of the evidence
The LNMTP also aims to ensure consistent London-wide adoption of policy and commissioning arrangements for decision-making on new drugs, while decommissioning therapies no longer deemed to be appropriate. It is expected that London cancer patients will benefit from the introduction of good-quality recommendations that take account of affordability, and that reduced variation between London PCTs would minimise costs and the number of complaints.
“Rational decision-making will avoid funding for only marginal benefit, and reduce pressures for IFRs,” said Dr Mitchell.
It was not clear, however, whether this centralisation of effort would conflict with the principle of more localised initiatives proposed earlier in the meeting by Professor Bosanquet.
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Discussion.