Independent Report Suggests Further Enhancements To NICE Methodology To Improve Evaluation Process For Cancer Medicines, UK

Main Category: Cancer / Oncology
Also Included In: Regulatory Affairs / Drug Approvals
Article Date: 20 Feb 2009 - 1:00 PDT

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An Office of Health Economics report launched suggests further enhancements to NICE's methodology for assessing cancer drugs more effectively. These are in addition to those already addressed by NICE's own end of life review.1

The report makes constructive suggestions for further adjustments to current methodology which may help establish more accurately the value to patients of cancer treatments being assessed by NICE. The report calls for changes to the health related quality of life measure preferred by NICE (EQ-5D) and an alternative public valuation of health states to fully reflect the importance of increasing survival and quality of life for patients with a very limited life expectancy. The report also supports the suggested changes to QALY calculations advocated in the recently issued supplementary advice by NICE to its Appraisal Committees on appraising life-extending, end of life treatments.2

The independent report, commissioned by the Pharmaceutical Oncology Initiative (POI), also calls for more research to determine the value patients attach to survival gains when their life expectancy is short and the patients' proximity to death to be considered more transparently and more systematically.

Professor Adrian Towse, Director at the OHE and co-author of the report, comments: "The recently published NICE advice on appraising life-extending, end of life treatments is very welcome. However, we believe that the methodology used for calculating and interpreting QALYs for cancer medicines could be further developed to better value the impact that these new medicines can have on patients and the NHS. The value patients with cancer attach to survival gains when their life expectancy is short is a key consideration. Our report is intended to be a constructive contribution to discussions about how NICE methodology for appraising cancer treatments could be improved."

Andrew Curl, Chair of POI, comments: "The POI believes that every cancer patient in the UK should have a chance of survival comparable to the best in Europe. NICE has declined to recommend some cancer drugs for use in the NHS which are routinely available elsewhere. This report was developed with the specific aim of helping to identify the necessary revisions and improvements needed to the current NICE methodology for appraising cancer treatments. If the recommendations within the report are implemented, the benefits to cancer patients in the UK now and in the future would be immense."

The Pharmaceutical Oncology Initiative (POI) is a group of eighteen pharmaceutical companies, all members of the ABPI, who have joined together to work with the NHS in improving access to cancer medicines across the UK.

A summary of the report is available on the OHE website at http://www.ohe.org

About the Report

The report was undertaken as part of a study commissioned by the Pharmaceutical Oncology Initiative. The report has been independently peer reviewed by Professor Nancy Devlin (City University) and Mark Sculpher (University of York), who are not responsible for its content. The OHE has retained editorial control of the report.

Further information about the Pharmaceutical Oncology Initiative (POI)

The POI was set up in 2005 and has already partnered with the Department of Health and the NHS to facilitate projects that enable people to gain better access to cancer services and medicines. The vision of the POI is to ensure that all people with cancer have access to the right medicines at the right time, giving them the best chance to fight cancer regardless of where they live.

1. Garau M, Shah K, Towse A, Wang Q, Drummond M, Mason A. Assessment and appraisal of oncology medicines: does NICE's approach include all relevant elements? What can be learnt from international HTA experiences? A report undertaken as part of a study commissioned by the Pharmaceutical Oncology Initiative Group (POI).

2. National Institute for Health and Clinical Excellence. Press release: 2008/066 NICE announces measures on end of life medicines, accessed via here. [Last accessed February 2009]

OHE

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