Tag: Lord Freyberg

The below Parliamentary question was asked by Lord Freyberg on 2015-11-30.

To ask Her Majesty’s Government what percentage of stage 2b cancer or higher patients in (1) tertiary, and (2) secondary, care centres were tested by NHS England in 2014 for genetic mutations that can confer resistance to targeted cancer therapies, in particular (a) AR amplification mutations, (b) ESR1 activation mutations, (c) PIK3CA mutations, (d) KRAS activation mutations, (e) EGFR amplification and activation mutations, (f) KRAS activation mutations, and (g) EGFR amplification and activation mutations.

Lord Prior of Brampton

NHS England has not, to date, undertaken a direct comparison of the English and French health systems in respect of genetic testing practice for cancer.

NHS England does not hold data on the percentage of stage 2b, or higher, cancer patients in secondary and tertiary centres who were genetically tested. Detailed information on the clinical circumstances, or reasons, for referral for genetic testing for individual patients is not currently collated on a national basis.

NHS England does not consider business cases from individual National Health Service trusts in relation to the adoption of new genetic tests. Instead, NHS England considers national clinical commissioning policy proposals on the eligibility of a particular test, or treatments to be made available in the presence of particular genetic markers. These are considered and where agreed, funded consistently across England for services falling within NHS England’s direct commissioning responsibilities.

Examples include the separate policies (published in July 2015) confirming eligibility for Ivacaftor for the treatment of cystic fibrosis in the presence of certain gene mutations, and confirming eligibility for testing for BRCA1 and BRCA2 gene mutations, respectively. Copies of the policies are attached.

In addition, the UK Genetic Testing Network currently presents new genetic testing proposals to NHS England for funding consideration based on the conclusions of their assurance programme. These are considered, alongside other new policy proposals, as part of the annual funding prioritisation process, where there is a net annual investment to be made to support their adoption.

Information on the average turnaround time for cancer genetic tests is not currently collated, or analysed, nationally. However, NHS England will be undertaking a procurement exercise in the coming months to support the strengthened provision of genetic testing across England. This includes more consistent reporting of activity and other performance indicators, including the timeliness of reporting on receipt on referrals. The supporting national service specification, setting out the standards required of commissioned providers, has been the subject of a recent public consultation.

The below Parliamentary question was asked by Lord Freyberg on 2016-01-25.

To ask Her Majesty’s Government what advice they received from the Wellcome Trust Sanger Institute during the set-up phase of Genomics England regarding the appropriateness in cases of cancer of using comparisons of tumour to normal whole genome sequencing at moderate sequence coverage, as opposed to focused actionable gene panel testing at deep sequence coverage; and what current technology is used by Genomics England.

Lord Prior of Brampton

The set up phase of the 100,00 Genomes Project was based on advice from Expert Working Groups which included experts from across the United Kingdom, including the Sanger Centre. The Working Group concluded that a more fundamental understanding of cancer would be delivered by whole genome sequencing compared to gene panels. This approach is part of the wider aim of the 100,000 Genomes Project to transform the National Health Service diagnostic pathway for patients and to build a dataset which will enable new scientific research. Adopting whole genome sequencing has already catalysed a fall in the costs which was also anticipated by the Expert Working Group.

The below Parliamentary question was asked by Lord Freyberg on 2016-04-21.

To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 17 March (HL7132), whether they expect any new database of innovative medicines to be constructed outside the normal information governance channels.

Lord Prior of Brampton

The Access to Medical Treatments (Innovation) Act 2016 will create a database of innovative treatments, when the Secretary of State directs the Health and Social Care Information Centre to establish such a database. The Centre will implement the database in accordance with the common law duty of confidence, data protection law and the information governance rules to which the Centre is subject.

The below Parliamentary question was asked by Lord Freyberg on 2016-07-19.

To ask Her Majesty’s Government whether they plan to consider providing interim funding for innovative treatments for patients with radioactive-iodine refractory differentiated thyroid cancer where there are treatments available but they are yet to be reviewed by NICE.

Lord Prior of Brampton

The Cancer Drugs Fund (CDF) already provides access to sorafenib as a treatment option for the systemic therapy of locally advanced or metastatic differentiated radioiodine-refractory thyroid cancer.

The National Institute for Health and Care Excellence (NICE) has been asked to develop technology appraisal guidance on the use of sorafenib and lenvatinib for this indication.

NHS England published its new standard operating procedure for the CDF in July 2016 and a copy is attached.

NHS England has advised that it considered carefully the issue as to which drugs should be given interim funding and concluded, with the support of the majority of stakeholders, that interim funding should only be possible for those drugs that had been granted a marketing authorisation and were in receipt of a draft positive appraisal recommendation or a draft recommendation for use within the CDF from NICE.