Cancer Drugs

Jo Churchill Excerpts

Tuesday 19th January 2016 Westminster Hall

[Jo Churchill (Bury St Edmunds) (Con)]

I thank my hon. Friend the Member for Mid Derbyshire (Pauline Latham) for calling a debate on an issue that is important not only to me and several of my constituents, but to the broader population.

The Cancer Drugs Fund is not fit for purpose. As the chief executive of Cancer Research UK, who chaired the independent taskforce that looked into the fund, pointed out, we have several problems. First, curative treatments cannot be accessed readily enough. Also, insufficient data are collected in the system to prove the benefits of drugs and their effectiveness for patients. Although we welcome the data collection that is taking place now, it is a little too late.

We continue to lag behind other countries in cancer recovery rates and appropriate prescribing. Indeed, 20% of cancer patients present at our accident and emergency wards, and the later a patient presents, the poorer the outcome. As the hon. Member for Scunthorpe (Nic Dakin) said, certain cancers, such as pancreatic cancer, are devastating in the speed with which they attack the individual.

It must be remembered that the Cancer Drugs Fund is unique: cancer is the only condition with a dedicated fund. My constituents and I welcome the Prime Minister’s support, but I am a little concerned that cancer is being labelled as a special disease. My surgery often includes patients with other diseases, and we must look across the piece. My concern is that we should have a road map from the accelerated access review so that we can learn how to drive forward advances not only for cancer, but for all areas of medicine. Standing in this hall takes me back six months, to when I first spoke here, about a constituent’s access to the rare-disease drug everolimus.

In a system that is challenged financially, we need to be very sure that any drug for whatever illness is effective and offers value for money. Within that landscape, the CDF has gone from its original four-year spend of £650 million to a six-year spend of £1.27 billion. It could be argued that it has been a victim of its own success.

With improved access to medicines for nearly 80,000 people, but with ever-increasing need and demand, it is right that the Cancer Drugs Fund should sit alongside the cancer strategy as part of the entire commissioning pathway. Non-surgical cancer treatments such as drugs can and should be incorporated into a treatment package of surgery and radiotherapy to deliver an integrated and effective approach. There is a need for radiotherapy machines right across our hospitals, because they deliver extremely high survival rates for cancer patients. We therefore need to be careful about these issues.

For me, the rub has been the lack of thought given to the removal of drugs, and like my hon. Friend the Member for Mid Derbyshire, I have been approached on this issue by constituents—particularly those suffering from pancreatic cancer and, given my history, those with breast cancer. A review in September led to 23 separate treatments being removed from the Cancer Drugs Fund, before we understood what the new horizon will look like for the charities and pharmaceutical companies, how the pathway will progress and whether we have a solution to ensure that our constituents can access drugs. In short, this removed the clinical choice from doctors and, more importantly, from patients. Those patients are my constituents and friends. With the loss of Imnovid and Revlimid—two drugs for myeloma—and the removal of breast, bowel and pancreatic cancer drugs for all those patients, life suddenly became less certain. A new CDF should have clear entry and exit levels for promising drugs. It needs to be a trial area, and defined as such; if, as proposed, it is to be brought into NICE, we need answers to some of the questions that other hon. Members have asked about how the Minister will hold NICE to account. In the cancer drug future, once a drug was approved it would be made available for routine use and would go into baseline commissioning. That would take some of the fear about whether someone would get it out of the system.

What remains to be seen is whether new drugs will have to meet the current inflexibilities of the cost-effectiveness criteria. That is a concern for cancer charities and pharmaceutical companies, which predominantly have the care of the patient, and patient outcomes, at their heart. To deliver cost-effective and timely treatments, as the hon. Member for Strangford (Jim Shannon) pointed out, we need a flexible new system. The NICE appraisal process is slow and unwieldy. It should be flexible enough to cope with new cancer drugs and—the Minister is aware of my interest in this—off-patent and repurposed drugs, which can also be effective in the area in question. That is about gathering and delivering the data on the patient for the patient, to allow drugs to be recommended and prescribed, or to make it possible to return to an individual pathway for a funding request. However, that merely sends us back to where we are today—people not knowing whether they will get the drug or not.

The irony of our system is that with the vibrancy of our life science industry, drugs are often readily available in Europe or Scotland before patients in England and Wales can access them. That is the bigger problem. We have improved one-year survival rates in the UK; but despite that we lag behind many other countries and our five-year survival rates have shown little progress. More must be done. In the world of pharmaceuticals and, more importantly, genomics, advances are happening at pace. We need a space where we can trial medicines for use not only in big cohorts but for rarer cancers and diseases. We need a landscape that will allow for the personalised medicine that is coming down the tracks to us. Cancer will not wait for NICE. Nor will it wait for the patient. I know: I have been diagnosed with cancer and pre-cancerous tumours on several occasions. That is why I challenge the Minister on behalf of other cancer patients and my constituents in need to ensure that the CDF delivers reforms that will improve patient access to effective cancer medicine.