Breast Cancer Drugs

Theresa Villiers Excerpts

Thursday 26th January 2017 Commons Chamber

[Mrs Flick Drummond (Portsmouth South) (Con)]

It is a pleasure to speak in the debate, and I congratulate the hon. Member for Mitcham and Morden (Siobhain McDonagh) on securing it. I was really honoured to be able to back the application to the Backbench Business Committee. I also thank her for her powerful speech, which was very moving.

Fighting cancer is not just a top priority for the NHS but one of the great scientific challenges of our time. Treating our illnesses with science rather than superstition is a relatively new idea in the history of medicine. However, the acceleration of better diagnosis, better treatment and more successful outcomes is keeping more of us alive for longer, and with a better quality of life.

The motion mentions Kadcyla, a treatment that NICE is not currently able to recommend for the treatment of secondary breast cancer, and we await the result of its consultation in March. This treatment is a relative of another medicine, which, in its introduction, was also extremely controversial—Herceptin. After a lot of consideration by NICE and a lot of debate and pressure from this House, Herceptin was approved. It has helped thousands of people—men get breast cancer too—in fighting breast cancer.

Kadcyla is a treatment that could help women who have already been on an Herceptin-based treatment and whose cancer has continued to advance. We must be clear when we talk about secondary, or metastatic, cancer that we are talking about people whose lives will be massively shortened by cancer. Kadcyla gives them and their families more time and a better quality of life. It can add months to the life expectancy of patients whose remaining lives are likely to be measured in only a few months. The hon. Lady movingly talked about some of her friends and some of those in the Public Gallery.

I think we all understand that there are ultimate financial constraints on the NHS, even though spending on it has increased. I really welcome the new cancer drugs fund, which provides patients with much better access to the most promising new cancer treatments, while providing value for the taxpayer.

[Mrs Theresa Villiers (Chipping Barnet) (Con)]

I was profoundly moved by the case of my constituent, Rosalie Marshall, who sadly is suffering from breast cancer. She told me that she finds it hard to understand why the NHS can spend such significant sums on conditions which, frankly, are not life-threatening and sometimes seem to verge on the cosmetic, and yet not give priority to vital drugs like Kadcyla. Surely something is wrong, and savings could be made in other parts of the NHS that would more than pay for Kadcyla.

[Mrs Drummond]

Yes, I also get emails on the same subject. We have to remember, though, that there are other considerations such as mental health conditions. Sometimes people do not quite understand why money is being spent on various parts of the NHS, but there are always other reasons behind it. However, I totally agree with my right hon. Friend about drugs like this which seem to make such a difference.

In the case of Kadcyla, there do seem to be questions as to why it cannot be brought into regular use. Some of those questions are for NICE and some are for the manufacturer. Kadcyla is a treatment that has been accepted by a number of European countries, despite the expense. I am reassured to see that many cancer charities accept that NICE has made every effort so far to fund it, and that NICE has been doing its best. However, there remains the question of how NICE’s apparent final position stands up by comparison with other European countries—France and Germany, for instance. France’s equivalent of NICE considered Kadcyla in exactly the same way as NICE has, and has approved it.

Another query is based on the choice of comparator treatment in assessing the quality of Kadcyla as a treatment. There have been concerns that the comparator treatment—Lapatinib and Capecitebine; I hope that Hansard will be able to report that rather better than I can say it—is no longer available on the NHS. The drug’s manufacturer carries the comparison on its own website, with the outcome of a clinical trial codenamed EMILIA. However, it does not seem realistic to base a decision on a drug on a comparison with another drug that is not available on the NHS either. It would help everyone to understand the comparison if it was made with a drug that is generally available.

Can the Minister tell us the status of Roche’s study under the name ESTHER, which is looking at Kadcyla? In the event that NICE does not revise its decision now, will it be open to it to do so when it gets the ESTHER conclusions? That trial is not scheduled to report until 2023, so the immediate concerns about availability remain. However, I recognise that research goes on constantly, and that perhaps the manufacturer will reconsider its position. It is unfortunate that NICE has been subjected to sustained attacks by the manufacturer, Roche, which has risked undermining NICE’s reputation in a most unjustified way. I call on Roche to get round the table with NICE and look again at the pricing of this drug, as it has done with others in the past.

Turning to other treatments, I know that the message is going out to clinical commissioning groups about the options available. Many Members will have had campaign emails relating to bisphosphonates, and I was reassured by the response I had from the Department of Health and the Portsmouth clinical commissioning group that they are being made available. Queen Alexandra hospital in Portsmouth has above-average performance in both treatment times and outcomes, and is becoming, if it is not already, a centre of excellence in cancer treatment.

I know that this is a difficult subject and budgets are limited, but like many others in this House, including those in the Gallery, many of my friends and family have died of breast cancer or are survivors. We need to make sure that we are keeping up with the right drugs to treat them, and that sounds like Kadcyla.