NHS patients waiting longer for new cancer drugs
Analysis by charity finds that while the rate of authorisation of new anti-cancer drugs is increasing, it is taking significantly longer for the drugs to reach patients.
Patients are waiting almost a year and a half longer for new cancer drugs to be made available on the NHS than they were a decade ago, a report from the Institute of Cancer Research (ICR) has found.
Between 2000 and 2008, it took an average of 12.7 years to take a patented discovery through drug development and licensing to final approval by the National Institute of Health and Care Excellence (NICE). Between 2009 and 2016, the average time to final NICE approval increased to 14.1 years.
In the report, the ICR — a research institute and cancer charity — assessed the current landscape for drug discovery and development by analysing each cancer drug first licensed through the European Medicines Agency (EMA) from 1 January 2000 to 31 December 2016.
In total, the EMA licensed 97 cancer drugs across 177 indications from 2000 to 2016. The report found that the rate of authorisations has almost doubled over that time period, with an average of 7.5 per year from 2000 to 2008 rising to 14.6 per year from 2009 to 2016.
Significant variation was seen across cancer types in terms of how many drugs were becoming available. Dramatic advances in treatments were seen for skin, breast, prostate and haematological cancers, but some relatively common cancers, including brain, oesophageal, bladder and womb cancer, had no new drug authorisations at all between 2000 and 2016.
Children also saw far slower progress in access to promising new treatments than adults; only 8 of the 97 drugs licensed during the time period were licensed for use in children’s cancer.
The report highlights that the development of genuinely innovative treatments still lags behind the unprecedented advances seen over the past decade in terms of understanding the genetics and biology of cancer.
The report details several reasons for this, including a lack of funding, limited access to tumour material and researchers being attracted to work on cancer types where there is already a track record of success.
“For some cancers, we are in an exciting new era of precision medicine — made possible by fantastic progress in discovering exciting new targeted medicines,” said Olivia Rossanese, head of therapeutics biology at the ICR.
“But we have seen far less progress against many other tumour types, and much less progress in children than in adults.
“We need to address the regulatory barriers in setting up and running clinical trials, and in getting drugs licensed at as early a stage as possible. We need academia to play a leadership role in encouraging drug companies to bring forward new models of trials as quickly as possible.”
Rossanese also said that the evidence suggested that NICE is not prioritising more innovative drugs. The report highlights that ‘highly innovative drugs’, which attack cancers through novel mechanisms or are part of a new class of chemical structure, were less likely to be approved by NICE than a ‘lower-innovation drug’, and that some drugs had “fallen through the gaps” and missed out on a NICE appraisal entirely.
“Cancer is a moving target — we need more drugs taking new approaches to targeting cancer, rather than more of the same ‘me too’ drugs that won’t lead to step-change improvements for patients.”
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205852
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