Pharma ‘shocked’ as drugs cut from Cancer Drugs Fund

Pharma companies have attacked the decision to remove some drugs from England’s Cancer Drugs Fund (CDF), in a move aimed at de-listing drugs which don’t offer value for money.

The list of drugs that will be cut from the CDF remains under wraps, but is thought to include two cancer drugs from Sanofi, which has attacked the decision.

The official announcement is expected to be made on Monday, but other drugs thought to been removed from the approved list include Eisai’s breast cancer drug Halaven (eribulin). The Daily Mail has also reported that Roche’s Avastin, Kadcyla, and Perjeta, Novartis’ Afinitor, and GSK’s Tyverb will also be de-listed for use in breast cancer after having been judged to offer ‘insufficient value for money’.

The £280m-a-year CDF – which provides funding for cancer drugs not included in baseline commissioning – is struggling to cope with escalating costs and NHS England is in the process of bringing in a new evaluation process for drugs proposed last November.

The preferred proposal placed on the table was to reduce the products and indications contained within the CDF to bring spending within budget and two of Sanofi’s drugs – prostate cancer therapy Jevtana (cabazitaxel) and Zaltrap (aflibercept) for colorectal cancer – are casualties of that process.

Sanofi confirmed to pharmaphorum that both its drugs are due for de-listing from 12 March – stressing that any patients currently on these treatments will not be affected by the decision – and said this was a “devastating blow” for patients relying on the CDF to fund their treatment.

“Removing Jevtana means patients with hormone resistant advanced prostate cancer have been left with no treatment options following initial chemotherapy,” said the company.

Sanofi’s general manager in the UK – Tarja Stenvall – said the company was “hugely shocked and disappointed” by the decision and will do “everything in our power to appeal this decision.”

That sentiment was echoed by Eisai, whose metastatic breast cancer therapy Halaven (eribulin) is also up for de-listing. Eisai UK president Gary Hendler said the company was “outraged” by the decision.

Eisai was joined in opposing the move by oncologist Dr Vivek Misra, consultant in clinical oncology at The Christie in Manchester, who said the decision would unfairly deny the drug to new patients, where previously thousands of women had benefitted from it.

There have been suggestions that companies whose products will be de-listed are considering a legal challenge to the decision, although this could not be confirmed at the time of writing.

NHS England – which manages the CDF – insists that measures have to be taken to tackle the overspend and that newer drugs are available which supersede those up for de-listing.

“The CDF has never been open to every product which has an indication for use in cancer – there has always been an assessment of clinical benefit,” it said at the time the changes were proposed.

“If the threshold used in that assessment was increased – and existing and new products and indications were evaluated against that new threshold – some products and indications would fall outside the CDF with an associated cost saving.”