Further blood cancer drugs made unavailable to patients in England

04 Sep 2015

NHS England announced today that seven different blood cancer drugs will be de-listed for 12 different blood cancer indications, making up nearly half of the total 25 cancer indications made unavailable to patients.

It's important to note that patients already taking any of the drugs for any of the indications de-listed in today’s announcement will be allowed to continue to take them. The changes come into effect on 4 November this year, ahead of a new system of drug provision due in April 2016.

Diana Jupp, Director of Patient Experience at Bloodwise, said:

“Today’s announcement will remove the only hope of effective treatment for many blood cancer patients.

“The existing system for approving new cancer drugs is clearly failing patients. Many blood cancer patients will be left in limbo until a long term solution is put in place next year. For some this will be too late. These drugs have been recognised as being clinically effective, yet patients in England will be denied access purely because the current system is broken.

“The Cancer Taskforce recently published its recommendations for improving cancer care to comparable levels of the rest of Europe. Ensuring that patients have access to the best drugs available is surely a key part of this.”

Many of these drugs de-listed are patients’ only hope. As an example, Brentuximab, which was only added to the Cancer Drugs Fund in January, is supported by a strong consensus among doctors that the drug represents a real step change in treatment for two indications. Yet today, these two indications have today been removed.

Dr Graham Collins, member of the Bloodwise Medical Advisory Panel and Consultant Haematologist at Oxford University Hospitals, said:  

“Brentuximab is the most effective single agent we have for relapsed anaplastic lymphoma.  The delisting of this drug means it is likely that patients in England will die if they are not able to access this treatment – it’s hugely detrimental to patients with this rare but life threatening disease.

“This drug has also become the standard of care in England for treating relapsed Hodgkin lymphoma following an autologous stem cell transplant, or for those failing two lines of treatment not suitable for a stem cell transplant. The de-listing of this treatment will make it harder for patients to receive curative treatment, inevitably making a cure a more difficult goal.”

The latest blood cancer drugs to be removed from the CDF are listed below. The de-listings apply to specific ‘indications’ for different types of blood cancer. The indication may describe the disease subtype, the specific stage of the disease or whether or not the patient has received previous treatment.

  • Bendamustine for the treatment of chronic lymphocytic leukaemia
  • Bendamustine for the treatment of relapsed mantle cell non-Hodgkin lymphoma
  • Bosutinib for the treatment of refractory chronic phase chronic myeloid leukaemia
  • Bosutinib for the treatment of refractory accelerated phase chronic myeloid leukaemia
  • Bosutinib for the treatment of accelerated phase chronic myeloid leukaemia
  • Brentuximab for the treatment of refractory systemic anaplastic lymphoma
  • Brentuximab for the treatment of relapsed or refractory CD30+ Hodgkin lymphoma
  • Dasatinib for the treatment of Philadelphia chromosome positive (Ph+) acute lymphoblastic leukaemia
  • Ibrutinib for the treatment of relapsed/refractory chronic lymphocytic leukaemia
  • Ibrutinib for the treatment of relapsed/refractory mantle cell lymphoma
  • Lenalidomide for the second line treatment of multiple myeloma
  • Pomalidomide for the treatment of relapsed and refractory multiple myeloma

The CDF was set up five years ago as a temporary measure to provide, on a case by case basis, cancer patients with access to drugs that were still being appraised or had been rejected by the National Institute of Health and Care Excellence (NICE). Drugs used to treat blood cancers are proportionally over-represented on the list of drugs only available to patients through the CDF.

The CDF is due for review in March 2016 and it's widely accepted that a more permanent and robust system is needed to evaluate which cancer drugs should be available to patients through the NHS in England.  Today’s news comes on top of the de-listing from the CDF in January of five additional drugs for eight different blood cancer indications.

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