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Cancer Medicines: Appraisals
13 June 2023
Lead MP
Jim Shannon
Strangford
DUP
Responding Minister
Will Quince
Tags
NHSEconomyTaxationNorthern Ireland
Word Count: 12428
Other Contributors: 6
At a Glance
Jim Shannon raised concerns about cancer medicines: appraisals in Westminster Hall. A government minister responded.
Key Requests to Government:
Shannon asked the Government to ensure that medicines currently in the Cancer Drugs Fund (CDF) can be assessed against the same criteria under which they were initially recommended for use in the NHS. He sought reassurance from the Minister regarding the potential reduction of access to certain drugs and requested flexibility in how drugs are allocated based on individual patient needs. The MP asks the government to support her four-point manifesto: (1) targeting 200 glioblastoma patients into clinical trials each year; (2) trialing brain tumour drugs on every licensed drug for other cancers; (3) ensuring medical oncologists are core members of neuro-oncology multidisciplinary teams; and (4) requiring mandatory training on brain tumours for doctors. She also requests that the Minister make a real impact in this area before standing down.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
Jim Shannon expressed concern about the UK's health technology appraisal process not keeping pace with cancer treatment innovations. He highlighted that over 320,000 people were on cancer waiting lists in July 2022 and noted that only 35.6% of urgent suspected cancer referrals from GPs began receiving treatment within the 62-day target in Northern Ireland by the final quarter of last year. Shannon also mentioned that NICE guidance is not automatically applicable in Northern Ireland, leading to challenges for cancer patients there. The MP is concerned about the lack of improvement in treating glioblastoma over the past 40 years. She highlights that the survival rate for glioblastoma remains at nine months on average, with only a marginal increase in five-year survival rates from 12% to 13%. The MP points out the disparity in survival rates between brain tumours and other cancers such as lung cancer and breast cancer, where significant improvements have been made. She also mentions that there are zero clinical trials for new glioblastoma drugs and no pharmaceutical companies willing to provide drugs for a new trial without personal intervention.
Andrew Gwynne
Ind
Gorton and Denton
Suggested that the Government should collaborate with the Welsh Assembly on a project to improve cancer care across the UK, aiming to make life better for all constituents through united efforts. He congratulated Jim Shannon for securing the debate, praised Siobhain McDonagh's case on brain tumours, highlighted personal experiences with cancer, mentioned a decline in commercial trials and its financial impact, raised concerns about regional variation in uptake of innovative medicines. Asked about additional community diagnostic centres being set up in his constituency. Inquired into clinical trials, expressing concerns about the UK losing its competitive edge. He mentioned the unacceptable gap in medicines for cancer patients and the need to regain a higher position in global rankings. He also noted that there are 780 new cancer cases each day.
Dwyfor Meirionnydd
She requested a meeting to discuss solutions, which was positively received by the Minister.
Dwyfor Meirionnydd
She congratulated the hon. Member on securing the debate and highlighted the importance of medical radioisotopes for cancer diagnosis and treatment, mentioning a potential shortage in the UK. She suggested that Project ARTHUR at Trawsfynydd could provide a domestic supply of these isotopes. The proposal for a medical radioisotopes facility in north Wales would complement Bangor University's Nuclear Futures Institute and its planned new medical school. The centre for doctoral training in nuclear energy futures at Bangor has had its application for renewal rejected by the Engineering and Physical Sciences Research Council, which is concerning given the shortage of clinicians.
Owen Thompson
SNP
West Aberdeenshire and Kincardine
Discussed the importance of addressing cancer treatment challenges, emphasising the need for a united front to push for improvements in the appraisal process for licensed medicines and access to innovative treatments. He expressed concern about the impact of Brexit on the appraisal and distribution of cancer medicines, highlighting shortages and delays in Scotland. He noted that the Scottish Medicines Consortium must review new medicines before NHS prescription and that difficult choices have to be made due to finite resources. Owen Thompson also mentioned concerns over budget cuts at the MHRA and the withdrawal of pharmaceutical companies from the payback scheme. He discussed the impact of funding cuts on pharmaceutical companies, GPs, and patients, emphasising that clinical trials are down by 41% since 2016.
Mitcham and Morden
It seems crazy that in a system as universal as the NHS there should not be access to outcome data. South West London Elective Orthopaedic Centre at Epsom Hospital, being the largest hip and knee replacement centre outside of America, has the lowest blood risks, lowest infection rates, and quickest turnaround time. This centre keeps its own data, making £1 million a year from it which could potentially fund the latest cancer drugs. Those 91,000 did not include people suffering from a glioblastoma; there are no drugs available for them. Laura Nuttall, who passed away at the age of 22 after being diagnosed with a glioblastoma aged 18, highlighted that brain tumours are the greatest killer of people under the age of 40. Made a powerful speech advocating for better treatment options for brain tumours, highlighted her sister Margaret's struggle with the disease. Called on pharmaceutical companies to increase research in this area. She shared her personal experience with brain tumours, discussing drug availability on the NHS and survival rates. She underlined the need for more awareness and training in hospitals and for better outcomes.
Tracey Crouch
Con
Chatham and Aylesford
Congratulates Jim Shannon on securing the debate, expressing gratitude for briefings received. Highlights issues with NICE's methods and processes for cancer drugs, noting survival rate disparities between the UK and US for glioblastoma. Acknowledges improvements in Kent and Medway's 62-day standard performance but expresses concern over access to new treatments due to changes in NICE's assessment process. Emphasises the importance of early diagnosis and data sharing to improve outcomes. She interjected briefly, sharing her personal experience of undergoing cancer treatment during the pandemic under hybrid working conditions. Tracey Crouch highlighted that this experience informed some of her contributions to the Procedure Committee. The pharmaceutical companies claim that a significant percentage—I cannot remember off the top of my head what it is—of drugs would not pass the test according to NICE's statistics. The Minister should meet with all interested parties, including pharmaceutical companies. She referenced the global survival rate for brain tumours, noting that it is 26% in the USA compared to just 10% in the UK. She also pointed out issues with early diagnosis and pharmaceutical companies.
Government Response
Will Quince
Government Response
Addressed concerns regarding cancer medicine appraisals by NICE, emphasizing that every pound spent on a new medicine is money not available for other services. Noted that the NICE approval rate for cancer medicines is around 92%. Acknowledged the need to collect national data and ensure patient voices are heard in decision-making processes. Discussed ongoing work with the pharmaceutical industry and VPAS negotiations, as well as efforts to improve clinical trials competitiveness through the O'Shaughnessy review. The Minister acknowledged the importance of personal experiences shared by Members, emphasising that the Government remains committed to making innovative and effective cancer treatments available. He highlighted NHS England's ability to negotiate commercial agreements for combination drug therapies and discussed progress in securing such treatments through deals like Keytruda and Lenvima. The Minister also stressed the role of NICE in health technology assessment and acknowledged the need for continuous improvement. He concluded by reiterating that this is not a political issue but one centred on patient care.
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Assessment & feedback
Summary accuracy
About Westminster Hall Debates
Westminster Hall debates are a chance for MPs to raise important issues affecting their constituents and get a response from a government minister. Unlike Prime Minister's Questions, these debates are more in-depth and collaborative. The MP who secured the debate speaks first, other MPs can contribute, and a minister responds with the government's position.