Cancer Commissioning—at a global and a local level: London Cancer New Drugs Group Annual Meeting

Discussion points

David Webb argued that the capacity of the NHS to implement a range of different PAS will soon be reached.

Some of the issues that were discussed included:

• Does a negative NICE ruling give pharmaceutical companies the opportunity to offer the NHS a PAS at a cheaper rate than would otherwise have been the case?
• PASs should not offer the opportunity to distort final NICE guidance
• Does more effective use of the NHS mean that staff should spend more time tracking 1-year survival data or on the administration of PASs?
• On the basis of commercial confidentiality, and due to the complexity of pulling these models together, pharmaceutical companies say it is difficult to reveal the evidence to the NHS upon which they are claiming cost-effectiveness for a new cancer drug
• Why do details of PASs remain confidential during the NICE process?
• Cancer service provider computer systems are not sufficiently sophisticated to administer multiple PASs, thereby denying providers the opportunity to offer patients access to cost-effective drugs
• Does PASLU have a role in evaluating risk-share schemes that operate outside of NICE technology appraisals and for which there are no NICE guidance criteria?
• Why can NICE not sub-contract cancer drug approval decisions to the robust processes already undertaken by local and regional bodies (e.g. the Scottish Medicines Consortium)?
• Does the fact that local health economies are not always able to recoup costs from NICE-approved PASs undermine the validity or integrity of PASLU decisions?

Prof Newland facilitating the discussion

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