Leukaemia: Medical Treatments
(asked on 10th November 2015) - View Source
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what comparative assessment his Department has made of the (a) cost and (b) effectiveness of stem cell transplants and tyrosine kinase inhibitor therapies as treatments for chronic myeloid leukaemia.
As the treatments referred to are mutually exclusive, NHS England has no plans to carry out such an assessment. Patients will only be offered a transplant when they are unsuitable for tyrosine kinase inhibitor (TKI) treatment, or if this treatment has failed.
Both imatinib (usually considered the first line option) and nilotinib are recommended by the National Institute for Health and Care Excellence as cost effective treatments for chronic myeloid leukaemia (CML). Dasatinib, bosutinib and ponatinib are only available for certain patients through the Cancer Drugs Fund.
In 2013, NHS England published a policy for the routine commissioning of allogeneic stem cell transplant for CML. This can be found at:
This policy allows for transplant in patients whose CML is refractory to TKI treatment, or where the patient is TKI intolerant. It takes into account expert advice from the British Society for Blood and Marrow Transplantation.
Based on the clinical pathway of care, no specific assessment of cost or effectiveness comparing blood and marrow transplantation with TKI has been undertaken.