Request
13 queries concerning the Cancer Drugs Fund. See response below for actual questions.
Our Response
I refer to your letter requesting information in respect of the East Midlands Cancer Drug Fund.
I can confirm in accordance with S.1 (1) of the Freedom of Information Act 2000 (FOIA) that we do not hold all of the information that you have requested. However, I will address each of your questions in turn:
Request 1
i) Describe the process NHS East Midlands SHA used to determine which drugs were approved for funding under the Cancer Drugs Fund from 1 April 2011 to 30 June 2011? Please indicate whether during this period you had a ‘priority list’ of eligible drugs.
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The East Midlands Cancer Drugs fund has a list of drugs and indications for treatment (a “priority list”) that was developed through discussions between East Midlands Specialised Commissioning Group and the oncologists and haematologists of the East Midlands Cancer Network. Clinicians were asked as part of the annual prioritisation and planning process to consider which therapies should be made available via the ICDF as representing clinically effective therapies that could be funded from the ICDF allocation for the region following decision of local PCTs not to routinely fund them. The Network has a well-established Cancer Drugs Advisory Group (CDAG) and this group, which is chaired by the Clinical Chair of the CDF Panel, is the forum for making recommendations for change to the priority list. The initial list was created in October 2010 but was extended following discussion by the CDAG in April 2011. All decisions are based on a Principles document that was widely consulted upon prior to the setting up of the fund. It is available on the East Midlands website at http://www.eastmidlands.nhs.uk/cancer-drugs-fund/.
ii) If you have a priority list, do you consider applications for funding drugs that are not on the list?
iii) If you have a priority list system, please indicate which of the following drugs are on the priority list for the treatment of cancers of primary origin in the breast
i) Abraxane
ii) Lapatinib –
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
iv) For each of the following drugs please explain what, if any, conditions were attached to the approval of funding these drugs between 1 April and 30 June 2011 through the Cancer Drugs Fund
i) Abraxane
ii) Lapatinib
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
1. Patients with metastatic or advanced Her2 expressing breast cancer with progressive disease following prior therapy which must include anthracyclines, taxanes and therapy with trastuzumab in the metastatic setting; or
2. Patients with significant cardiac dysfunction who run significant risk of cardiac failure, which excludes them from the use of trastuzumab (Herceptin®)
v) If NHS East Midlands uses priority lists, what criteria were used between 1 April and 30 June 2011 for assessing which drugs should be placed on the priority list and which should not?
vi) If NHS East Midlands SHA uses priority lists, what criteria, if any, were used for assessing drug applications made for drugs not on the priority list between 1 April 2011 and 30 June 2011?
vii) If NHS East Midlands SHA did not have a priority list between 1 April and 30 June 2011, what criteria were used for assessing drug applications?
Request 2
Did NHS East Midlands SHA receive any requests either individually or in combination for funding from the Cancer Drugs Fund between 1 April 2011 and 30 June 2011 for each of the drugs listed below. Please indicate ‘yes’ or ‘no’ for each drug.
i) Abraxane
ii) Lapatinib
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
Request 3
Does NHS East Midlands SHA count applications for funding from the Cancer Drugs fund for one patient for a combination of drugs as one application?
Request 4
what is the total number of applications for funding from the NHS East Midlands SHA’s Cancer Drugs Fund that were made for each calendar month from 1 April 2011 to 30 June 2011 for treatment of cancers of primary origin in the breast
Request 5
What is the total number of applications for funding from the NHS East Midlands SHA’s Cancer Drugs Fund that were approved for each calendar month from 1 April 2011 to 30 June 2011 for treatment of cancers of primary origin in the breast
Request 6
What is the total number of applications for funding from the NHS East Midlands SHA’s Cancer Drugs Fund that were made for each calendar month from 1 April 2011 to 30 June 2011 that included (either individually or in combination) the following drugs
i) Abraxane
ii) Lapatinib
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
Request 7
What is the number of applications for funding from the NHS East Midlands SHA’s Cancer Drugs Fund for each of the drugs listed below in each calendar month from 1 April to 30 June 2011? Also, if this information is available, please detail whether these requests were made individually or in combination. We have enclosed a form which you may find useful when responding.
i) Abraxane
ii) Lapatinib
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
Request 8
How many applications for funding from the NHS East Midlands SHA were approved for each calendar month from 1 April 2011 to 30 June 2011 for the following drugs, individually or in combination, with the information listed by drug. Please also indicate where the drugs were requested in combination. We have enclosed a form which you may find useful when responding.
i) Abraxane
ii) Lapatinib
iii) Vinorelbine (oral)
iv) Bevacizumab
v) Fulvestrant
vi) Gemcitabine
vii) Sunitinib
viii) Trastuzumab
ix) Eribulin
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East Midlands SHA receives a monthly report on applications to the fund by drug and on the number of applications approved, pending and rejected. Both reports are publicised on the SHA’s website at http://www.eastmidlands.nhs.uk/cancer-drugs-fund/. We do not hold information to the level of detail that you have requested.
Request 9
What appeals process did NHS East Midlands SHA have in place for the Cancer Drugs Fund between 1 April 2011 and 30 June 2011?
Request 10
I. How many appeals relating to the Cancer Drugs Fund were made to NHS East Midlands SHA in total from 1 October 2010 to 30 June 2011?
II. How many appeals were made to NHS East Midlands SHA for funding under the Cancer Drugs Fund in each calendar
a. month from 1 October 2010 to 30 June 2011, listed by drug type?
III. What proportions of appeals were successful from 1 October to 30 June 2011?
IV. How many appeals were made in each calendar month from 1 October 2010 to 30 June 2011 for drugs for the treatment of cancers of primary origin in the breast?
V. What proportion of appeals were successful for drugs for the treatment of cancers of primary origin in the breast, in calendar month from 1 October 2010 to 30 June 2011?
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Since the commencement of the fund in October 2010 fewer than 5 requests to the SHA Review Panel have been made. We are therefore of the opinion that Section 40 of the FOIA is engaged in this instance as this information relates to less than five members of staff in line with current guidance available to us on the use of small number data. The purpose of section 40 of the Act is to protect personally identifiable information and the privacy of living persons. Due to the small numbers involved, we will not provide further information due to the risk of divulging patient identifiable information.
Request 11
How much money has been allocated to NHS East Midlands SHA for the Cancer Drugs Fund for the year April 2011/12?
Request 12
How much money did NHS East Midlands SHA spend between 1 April 2011 and 30 June 2011 on funding drugs via the Cancer Drugs fund?
Request 13
What proportion of the NHS East Midlands SHA’s Cancer Drug fund allocation for the year April 2011/12 was used between 1 April 2011 and 30 June 2011?
I hope that this information is of use. If you are dissatisfied with the way in which we have dealt with your request you can ask us to review our decision by writing to:-
Mr Moosa Patel
Director of Corporate Affairs
NHS East Midlands
Octavia House
Interchange Business Park
Bostock's Lane
Sandiacre
Nottingham
NG10 5QG
If at the conclusion of any review you remain dissatisfied you may complain to the Information Commissioner who can be contacted at:-
The Office of the Information Commissioner
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF
