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New treatments for advanced cancer: an approach to prioritization
J S Ferguson1, M Summerhayes, S Masters
1Lambeth, Southwark and Lewisham Health Authority, 1 Lower Marsh, London, SE1 7NT.
Abstract:
The allocation of funding for new anticancer treatments within the UK has not kept pace with demand. Clinicians find themselves restricted in the use of licensed drugs which they feel are in the best interests of individual patients. Against this, health authorities have a duty to ensure that scarce resources are used equitably to meet the needs of the local population as a whole. Differential levels of funding for new treatments across the country have led to concerns about rationing by postcode. This paper outlines an approach to the prioritization of new treatment for advanced cancer developed jointly by clinicians and health authorities in South London. The approach involves evidence reviews and consensus meetings. Existing and new treatments are rated on a four-point 'relative effectiveness scale', which takes account of the impact of the treatment on quality of life and on survival. The strength of evidence supporting each effectiveness rating is also classified. Health Authorities have used these ratings to determine overall funding levels, while leaving decisions on individual patients to the relevant Trusts.
Insights
Funding for new cancer treatments in the UK is insufficient, leading to postcode rationing. A South London initiative prioritizes advanced cancer treatments using evidence reviews and a relative effectiveness scale to ensure equitable resource allocation.
Area of Science:
- Oncology
- Health Economics
- Health Services Research
Background:
- Limited funding for novel anticancer therapies in the UK restricts clinical options.
- Disparities in treatment funding across regions raise concerns about inequitable access ('rationing by postcode').
- Healthcare authorities face the challenge of balancing individual patient needs with equitable resource allocation for the wider population.
Purpose of the Study:
- To outline a collaborative approach developed by clinicians and health authorities in South London for prioritizing new advanced cancer treatments.
- To establish a systematic method for evaluating and comparing the effectiveness of existing and novel cancer therapies.
Main Methods:
- The approach integrates evidence reviews and consensus meetings involving both clinicians and health authorities.
- Treatments are assessed using a four-point 'relative effectiveness scale' considering quality of life and survival impacts.
- The strength of evidence supporting each treatment's effectiveness rating is also systematically classified.
Main Results:
- The developed framework provides a structured method for rating the relative effectiveness of cancer treatments.
- This system allows for the classification of the evidence supporting each treatment's effectiveness.
- Health Authorities utilize these ratings to inform overall funding decisions, while Trusts manage individual patient treatment choices.
Conclusions:
- The South London prioritization approach offers a transparent and evidence-based method for allocating resources to advanced cancer treatments.
- This framework aims to address the demand-supply gap and mitigate concerns regarding geographical disparities in treatment access.
- Collaborative development between clinicians and health authorities is crucial for effective and equitable resource management in cancer care.