On day one of cancer fund overhaul, NICE faces new calls for reform

Today is the first day for England’s drug cost watchdog to take the reins of the beleaguered Cancer Drugs Fund and the moment it took over, NICE faced criticism from a top drugmaker over how it intends to run the fund.

Under the new setup, NICE is tasked with deciding which meds currently funded by the CDF will stay and which will go. But in a statement, Roche said the U.K. government should overhaul NICE’s review methodology “to stop patients facing ongoing anxiety around the availability of existing and new cancer medicines.”

While 37 of 39 indications remain on the CDF and will be reviewed by NICE, Roche pointed out that the 10 of those had previously been rejected for NHS use under the "unreformed appraisal system," based on their cost-effectiveness. 

“This could mean that thousands more cancer patients are denied medicines their doctors believe could be effective in their treatment,” Roche UK general manager Richard Erwin said in a statement.

Months in the work, the overhaul is part of an effort to reel in the Cancer Drugs Fund following budget overruns, leading many to believe that some expensive cancer drugs will be without coverage as the reviews unfold.

As part of the cost control efforts, CDF last September jettisoned 16 drugs from coverage, triggering outrage from pharma execs and concern from treatment charities. At the time, Roche CEO Severin Schwan said the decision was “stupid” and “completely arbitrary.” In the new statement, Roche said it’s concerned over a new delay on breast cancer med Perjeta.

But in the first about-face since starting the reappraisals, NICE earlier this month gave its thumbs up to Pfizer’s Bosulif for patients with Philadelphia chromosome–positive chronic myeloid leukemia who have either failed on other treatments or suffered side effects too severe to continue. The move reversed a 2013 decision and will enable the drug to be routinely available through England’s National Health Service.

The Swiss pharma isn’t alone with its concerns, as in recent weeks AstraZeneca and Eisai have gone public with their NICE grievances. AstraZeneca, upset about a delay for its new lung cancer med Tagrisso, called for governmental reform last week. Eisai said it’d have to rethink its commitment to England, plus consider legal action, over a delay of thyroid cancer medicine Lenvima, a drug it makes in the U.K.

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