Breast Cancer: Innovative Drugs

Lord Prior of Brampton Excerpts

Monday 24th October 2016 Lords Chamber

[Baroness Massey of Darwen]

To ask Her Majesty’s Government whether the Accelerated Access Review will address the availability of innovative drugs for breast cancer.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, the report of the Accelerated Access Review, published today, makes recommendations to the Government on reforms to accelerate access for National Health Service patients to innovative medicines and medical technologies, which may include drugs for breast cancer, making our country the best place in the world to design, develop and deploy these products. I warmly welcome publication of the report. The Government will consider the recommendations in the review carefully and provide a formal response in due course.

[Baroness Massey of Darwen (Lab)]

I thank the Minister for that Answer. I am aware that, fortuitously, the final report of the Accelerated Access Review was published this morning, and, again, it is fortuitous that Thursday of this week will be breast cancer awareness day. The Secretary of State for Health has commented that we wish to make the UK the best place in the world to develop new drugs, as the Minister said. Do the Government therefore intend to commit to full delivery of the Accelerated Access Review, and what estimates have been made of the resources that will be necessary for this, if any resources are required?

[Lord Prior of Brampton]

We received the report today. We warmly welcome its principles and believe that by combining the great depth of our research base in this country with the NHS, which is the largest single integrated provider of health services in the world, we can create a world-leading life sciences base in this country. The detailed response to the report and the costs attached to it will come in due course.

[Baroness Walmsley (LD)]

My Lords, repurposed off-patent drugs often fall in the cracks between the processes of NICE and the processes of NHS England, both of which organisations take the role of approving these drugs. The Accelerated Access Review recognises this problem and recommends that the new streamlined process involve both organisations talking to each other to make quite sure that that does not happen. What will the Minister’s department do to ensure that under this new streamlined process these drugs do not fall between the cracks, because many of them are very useful to patients?

[Lord Prior of Brampton]

My Lords, I need to consider the report in detail. I do not believe that repurposed generic drugs naturally fall within the AAR streamlined procedures, although it is very important that they do not fall between the cracks. The AAR is largely designed for new products rather than for repurposing old products.

[Baroness Greengross (CB)]

As the Minister will know, there is an enormous delay in innovative drug production due to the regulatory bodies internationally not working very closely together or taking a very long time to work together. Will the Minister tell us whether there has been any progress on bringing those regulatory bodies together, as was initiated after the former Prime Minister did a lot of good work in this respect regarding dementia?

[Lord Prior of Brampton]

The noble Baroness is absolutely right. The delay in bringing a new drug to the market can very often be between 12 and 14 years, which is a huge amount of time. Part of the reason for that is indeed the regulatory process. The whole purpose of the Accelerated Access Review is to truncate that time. The report talks about reducing for some drugs the time it takes to bring them to market by up to four years, which would be very considerable progress. In terms of international regulatory bodies, if one takes the EMA in Europe and the FDA in the US, clearly they do work together at one level but probably not closely enough, and I suspect that there is too much duplication in regulation. Certainly, as we leave the European Union, we need to be very careful that we do not have a duplicatory regulatory system in this country.

[Baroness Wheeler (Lab)]

My Lords, the Minister will know that since 2014 the Government have received nearly £1.5 billion from the branded pharmaceutical sector as part of the PPRS to hold down pharmaceutical costs. Why is not some of that sum being used to fund innovative drugs for breast cancer?

[Lord Prior of Brampton]

My Lords, I think it is a mistake to regard the PPRS and the savings made in that scheme as a separate pot of money. Any savings generated from the PPRS are funnelled back into the NHS. As for new innovative drugs, the cancer drugs fund has been changed substantially and one should regard it now largely as an incubator fund with the same purpose as the Accelerated Access Review, which is to bring forward new drugs more quickly.

[Lord Hamilton of Epsom (Con)]

Can my noble friend give the House some indication of the costs of bringing new drugs on to replace old? Invariably, new drugs are far more expensive than the ones that they replace.

[Lord Prior of Brampton]

My noble friend makes a perceptive point. There is always going to be tension between new drugs and affordability, although there are new drugs and new medical devices that can, in the long run, actually save money. The whole purpose of the Accelerated Access Review is to try to square the circle. There are three factors that we have to consider: first, we want a strong and vibrant life sciences industry in this country; secondly, we want to bring forward new drugs as soon as possible if there are big patient benefits; and thirdly, it must be affordable.

[Baroness Finlay of Llandaff (CB)]

Following the statement of the Academy of Medical Royal Colleges this morning urging caution over chemotherapy in advanced cancer, does the Minister agree that it is very important that, at the time of diagnosis, patients have a serious illness conversation and are prepared for what might come so that they are not hanging on with false hopes for drugs which might not be of benefit to them but can have treatments that are appropriately targeted to the individual patient and their needs?

[Lord Prior of Brampton]

The noble Baroness is describing good clinical practice. One would hope that that conversation would take place between a doctor and patient. What was disturbing about the report from the Academy of Medical Royal Colleges was its overall estimate that £2 billion a year was being wasted on unnecessary tests, drugs and the like. The issue that the noble Baroness raises is where people’s lives are prolonged right at the end but they are not given any quality of life at the same time.