March 2, 2017

expert reaction to NICE reviewing cancer drugs on the old Cancer Drugs Fund, and recommending two bowel cancer drugs for routine use

The National Institute for Health and Care Excellence (NICE) has published new guidance which recommends Cetuximab and panitumumab, for previously untreated metastatic colorectal cancer, be moved from the Cancer Drugs Fund into routine use.

Prof. Karl Claxton, Professor of Economics, University of York, said:

“The proper appraisal of these cancer drugs by NICE is to be welcomed and the discounts the manufacturers have offered demonstrates that price negotiation is only possible when we are not willing to say yes at any price.

“The scale of the discounts that have been offered are confidential but they are unlikely to be enough to ensure the benefits of these drugs are greater than the harm done elsewhere as the additional costs must be found from existing NHS care.  This is because the criteria used by NICE in approving these drugs doesn’t match the evidence of how much the NHS can afford to pay for the benefits they offer.  As a consequence the routine funding of these drugs, with money that must be found by local NHS commissioners, will mean that the harms for other NHS patients will far exceed the benefits they offer.

“Moving these drugs into routine commissioning to make room for other, even less affordable drugs, to be funded in the CDF is not good news for the NHS.  All the evidence suggests that health outcomes overall will be damaged and especially at a time when the NHS and local commissioners are under considerable financial pressures.

“The existing national rebate mechanism needs to be reformed so that rebates paid by manufacturers reflect the difference between the prices they charge for new drugs and how much the NHS can afford to pay for the benefits they offer.  Local commissioners and prescribers also need to receive these rebates more directly so they can afford to use these new drugs quickly without undermining effective care for other NHS patients.”

* ‘National Institute for Health and Care Excellence, Final appraisal determination – Cetuximab and panitumumab for previously untreated metastatic colorectal cancer’ was published by NICE on Thursday 2 March 2017. 

Declared interests

Prof. Karl Claxton: Prof. Karl Claxton is a faculty member of the Roche Payer Evidence Council.