Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, with reference to the absence of a remission timeframe in the recommendation of NICE on the treatment of chronic lymphocytic leukaemia, for what reason NHS England does not prescribe ibrutinib to patients who have been in remission for more than three years.

We have been informed by NHS England that, since 25 April 2017, it has routinely commissioned ibrutinib for relapsed / refractory chronic lymphocytic leukaemia and chronic lymphocytic leukaemia with 17p deletion or TP53 mutation. Prior to this, ibrutinib was funded via the Cancer Drugs Fund.

NHS England has advised that the basis of the National Institute for Health and Care Excellence’s (NICE) assessment of the clinical effectiveness of ibrutinib was a clinical trial (PCYC-1112). The trial’s patient inclusion criteria included a caveat that patients should have failed to respond or had a progression free survival of less than three years (from first dose of treatment with a purine analogue-based therapy and anti-CD20 containing chemo-immunotherapy after at least two cycles).

The treatment criteria set by NHS England are derived directly from the full NICE Guidance document, including the evidence and studies upon which the NICE Committee relied in order to make a positive recommendation as to the drug’s clinical and cost effectiveness.