Variations in use of NICE-approved drugs reducing
Variations across England in access to cancer drugs approved by the National Institute for Health and Clinical Excellence are reducing, according to a report
from national cancer director, Mike Richards, published last week. The report makes several recommendations, many of which cancer network pharmacists could get involved in.
The report follows on from a baseline review, conducted between July
and December 2003, which showed that, although overall use of cancer
drugs generally increased after a positive NICE appraisal, considerable
variation in use of the drugs remained between cancer networks.
The latest review, conducted between January and June 2005, shows that
this variation in use of all NICE-approved cancer drugs has reduced.
It also shows a median increase in uptake of cancer drugs following positive
NICE guidance of 47 per cent, ranging from 11 per cent for vinorelbine
and fludarabine to 120 per cent for temozolomide.
The review looks at all 16 cancer drugs appraised by NICE (15 of which
received a positive appraisal) plus four standard cancer drugs as comparators.
The report recommends that cancer networks should plan ahead and regularly
monitor uptake of NICE-approved drugs to ensure that the level of variation
is reduced as much as possible. A capacity planning tool developed by
the Association of the British Pharmaceutical Industry, the Department
of Health Cancer Action Team and the NHS Cancer Services Collaborative
will be ready for roll out to cancer networks next month. Central money
to support the purchase of chemotherapy e-prescribing systems has been
made available and networks should capitalise on this, it adds.
David Thomson, chairman of the Cancer Network Pharmacists Forum and lead
pharmacist for Yorkshire Cancer Network, told The Journal that the recommendations
in the report highlight some key areas that pharmacists could get involved
in, including monitoring the NICE website, using the capacity planning
tool, e-prescribing and monitoring uptake of drugs.
“This is an opportunity to tell cancer networks that they need
to think about employing a pharmacist,” he said. Currently, just
under half of cancer networks include a pharmacist.
Libby Hardy, lead pharmacist for Peninsula Cancer Network, said that
the report shows that action plans provided by those networks in which
drug use was found to be low in the first review have been successful. “In
many situations the under-usage was as a result of capacity limitations
within the acute trusts,” she said. However, she added that there
are some limitations in the accuracy of the data in the latest report,
and for that reason, caution should be exercised when comparing the usage
directly between cancer networks.
“Once [the e-prescribing systems for chemotherapy] are operational,
cancer networks using e-prescribing should be able to provide accurate
data
on the use of all chemotherapy drugs. They should also be able to link
the treatment with the stage and type of tumour,” said Dr Hardy. |
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