Cancer Patients Are Kept In The Dark Surrounding Treatments Awaiting NICE Approval, UK

Main Category: Lymphoma / Leukemia
Also Included In: Cancer / Oncology
Article Date: 27 Aug 2008 - 3:00 PST

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One in four doctors choose not to discuss life extending cancer treatments that are awaiting NICE (National Institute for Health and Clinical Excellence) approval with their patients. The research, commissioned by Myeloma UK, also revealed that 75 percent of doctors receive no guidance on discussing the availability of these treatments with their patients and a fifth of doctors believe that prescribing new treatment options for myeloma is completely 'out of their hands'.[i]

The research, conducted with 103 myeloma specialists in England, Wales and Scotland, showed that lengthy NHS bureaucracy puts cancer patients' lives at risk with three-quarters of doctors reporting a delay of over a month when applying for funding for myeloma treatments awaiting or undergoing a NICE appraisal. In addition, the majority of doctors (74 percent) reported to have been in a situation where applications for their preferred treatment option were rejected by Primary Care Trusts (PCTs) with cost cited as the main reason for the knock back.1

Dr Atul Mehta, haematologist consultant at the Royal Free Hospital, London, commented, "These survey findings reveal the dismal state of UK cancer management. Despite significant advances in the treatment of myeloma, such as Revlimid, the majority of patients cannot get access to new life-extending drugs until they have been appraised and approved by NICE - a process that can take up to three years from when the drug is first licensed in the UK. Patients with active myeloma require effective treatment to improve their chances of survival. The impact of waiting even a month for treatment can result in a life or death situation."

NICE is currently reviewing a number of treatments for myeloma including Revlimid (lenalidomide), a breakthrough oral therapy, which could extend life by three additional years compared to the standard of care.[ii] Revlimid gained its UK license in June 2007 and NICE is expected to make its decision in 2009. Until then, patients in the UK will struggle to get access to this treatment due to NHS funding processes for treatments not yet approved by NICE. However, Revlimid is widely available across Europe and fast becoming the new standard of care.

Eric Low, Chief Executive of Myeloma UK, added, "It is appalling that myeloma patients cannot get access to life extending treatments, which are widely available throughout Europe. Post code prescribing is rife in the UK with some patients getting access to life extending treatments ahead of a NICE decision whilst others are left to die. Myeloma UK wants to engage with the Department of Health to find a solution to this growing issue."

Myeloma is a terminal cancer of the plasma cells. Plasma cells are found in the bone marrow and are responsible for protecting the body against infection. In myeloma, a single defective plasma cell multiplies rapidly, displacing the healthy bone marrow. There are nearly 3,800 new cases of multiple myeloma in the UK per year with more than 2,400 people dying from the disease annually.[iii]

The 'Treating Myeloma in England, Wales & Scotland 2008' research was commissioned by Myeloma UK and supported by an educational grant from Celgene Ltd. The research was carried out by Eggington Research Associates Ltd.

[i] 'Treating Myeloma in England, Wales & Scotland' 2008' conducted by Eggington Research Associates Ltd.

[ii] J. Ishak, et al., "Modeling overall survival in the event of patient cross-over from dexamethasome to lenalidomide in phase III multiple myeloma trials" presented at the British Society for Haematology (BSH) meeting in April 2008 in Glasgow.

[iii] Cancer Research UK. UK Multiple myeloma incidence statistics. http://info.cancerresearchuk.org/cancerstats/types/multiplemyeloma/incidence/ Accessed February 2008.

Myeloma UK