Breast Cancer: Health Services

(asked on 17th April 2023) - View Source

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the accessibility of (1) medicines, and (2) clinical interventions, for secondary metastatic breast cancer in England.


Answered by
Lord Markham Portrait
Lord Markham
Parliamentary Under-Secretary (Department of Health and Social Care)
This question was answered on 2nd May 2023

The Government is committed to supporting timely patient access to clinically- and cost-effective new drugs, including for metastatic breast cancer. The Medicines and Healthcare products Regulatory Agency, the National Institute for Health and Care Excellence (NICE) and NHS England are working closely together to ensure that there is a joined-up, timely approach to supporting access to new medicines for National Health Service patients, including those licensed through Project Orbis and the creation of the Innovative Licensing and Access Pathway (ILAP). For example, average times taken between licensing and the publication of NICE guidance for new medicines have been reduced from 10.2 months for 2017/18 to 3.1 months for 2022/23. The proportion of positive NICE recommendations increased from 79% in 2017/18 to 92% in 2022/23.

NICE is also able to make recommendations through the cancer drugs fund (CDF), which has benefitted over 88,000 patients as of March 2023. The CDF has allowed patients with metastatic breast cancer to access new medicines like trastuzumab deruxtecan and palbociclib, while allowing for the collection of further data on their clinical and cost effectiveness to inform a final NICE recommendation.

NICE published a surveillance review of its guideline on advanced breast cancer in January 2023. It concluded that the recommendations on biological therapy, chemotherapy, psychological support and preventing and managing complications will be updated. These updates will be scheduled into NICE’s work programme and will include equality impact assessments and consultation with stakeholders to ensure access issues are fully considered.

The NHS Cancer Programme has commissioned five new cancer clinical audits, which will provide timely evidence for cancer service providers of where patterns of care in England may vary, increase the consistency of access to treatments and help stimulate improvements in cancer treatment and outcomes for patients. The Royal College of Surgeons began work on this audit in October 2022 with the first outcomes expected in 2023/24. One of the five audits will cover primary and metastatic breast cancer.

The Department has not had specific discussions with the Devolved Governments. However, the Welsh Government and the Northern Ireland Department of Health have agreements in place with NICE to use their technology appraisals and clinical guidelines. NICE will engage with them to support implementation. Both NICE and the Scottish Medicines Consortium are permanent partners in ILAP. Decisions on how guidance is implemented is a matter for each Government.

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