Cancer patients given new drugs that won’t help them. GPs needed in oncology clinics…

If commissioning groups insisted that oncology clinics had a GP present, and that he was involved in decision making with the patient, and especially the decision to move from oncology cancer care to palliative  or terminal care, there would be far less wastage. There is an issue: there are not enough GPs. Undercapacaity means the most pragmatic way would be a phone call to the GP BEFORE any decision on treatment is taken. The savings involved, the quality of life gained, and the honesty of such teamwork seems to be unimportant… 

Image result for oncology cartoon

Chris Smyth in the Times reports 5th October 2017: Cancer patients given new drugs that won’t help them

Most new cancer drugs are given to patients without any evidence that they extend or improve lives, an overview of data has concluded.
Only half show they have any real benefit, according to researchers who say regulators must make it harder for medicines to be approved. Other care for patients is being rationed to pay for drugs that are often useless, they add.
Regulatory approval, however, does not mean the NHS will pay for the drugs. Health chiefs will see the study as vindication of a tougher line which has seen them rejecting many new medicines as poor value for money.
NHS England yesterday defeated a legal challenge to its decision to add an extra layer of rationing to new medicines. Even cost-effective treatments can now be delayed or restricted if the total cost to the NHS exceeds £20 million a year, after a High Court judge refused the Association of the British Pharmaceutical Industry (ABPI) permission to take the plans to judicial review.
In an effort to assess the effectiveness of new medicines, scientists looked at data on all 68 cancer treatments approved for routine use by the European Medicines Agency between 2009 and 2013. They found that only 35 per cent had been shown at the time to lengthen patients’ lives.

A further 7 per cent could show they improved patients’ quality of life, according to data published in The BMJ. Instead, drugs were approved on the basis of studies that looked only at interim measures, such as how many patients responded, or how long the disease went without worsening. However, these turned out to be poor markers that patients would live longer, with just 7 per cent of drugs without a survival advantage when they were approved going on to demonstrate one over the next five years.

Overall, no more than 51 per cent of the treatments approved have shown any benefit in terms of life expectancy or quality, they say.

Courtney Davis, of King’s College London, who led the study, said patients often did not realise that the drugs they were offered had not been shown to extend life. “What people often don’t realise is that it’s not just resources taken away from other disease areas, they are also being taken from other cancer treatments that are actually more effective than drugs.”

Many of the best-known treatments approved during the study have been shown to extend life, including abiraterone and enzalutamide for prostate cancer, and Herceptin and Kadcyla for breast cancer.

Paul Catchpole, of the ABPI, said: “It can take many years to gather overall survival data on new medicines, which is why meaningful surrogate outcomes are used by regulators so that promising new medicines can be provided to patients whilst further evidence is collected. These cancer patients often have no other remaining options.”

This entry was posted in A Personal View, Commissioning, Consultants, General Practitioners, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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