Using routinely collected population healthcare data, including systemic anti-cancer therapy (SACT) data, to inform commissioning decisions through the Cancer Drugs Fund (CDF)


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Alice Turnbull1,Sarah Lawton1,Martine Bomb1,Rebecca Smittenaar1
1Public Health England

Abstract

Background

The National Institute of Health and Care Excellence (NICE) appraises all new cancer drugs to determine whether they are clinically and cost-effective, and should enter routine commissioning. If current evidence results in uncertainty, the new Cancer Drugs Fund (CDF) enables a period of additional data collection, designed to answer uncertainty, whilst patients benefit from interim treatment access.

National Health Service (NHS) treatment providers in England submit regular cancer data to the National Cancer Registration and Analysis Service (NCRAS) at Public Health England, including the systemic anti-cancer therapy (SACT) dataset. The SACT dataset offers a unique source of national, real-world data, which describes treatment patterns and outcomes, and helps address NICE uncertainty.

Method

NCRAS use routinely collected cancer data to evaluate patients treated through the CDF. This includes information on patients’ tumours, the drugs and regimens they received, their treatment outcomes and clinical team. NCRAS produces reports evaluating treatment patterns and outcomes such as overall survival and treatment duration; linkage to other NCRAS and NHS datasets allows additional outcomes to be reported, such as the proportion of patients receiving a stem cell transplant.

A team of data liaison officers at NCRAS support providers to improve SACT data quality and completeness. Interim updates are shared with NICE and the relevant pharmaceutical company, detailing case ascertainment and data completeness.

Results

Currently, routinely collected data, including the SACT dataset, is the primary information used to answer NICE uncertainty for 25% of CDF treatments; in other cases, NCRAS reports complement randomised controlled trial results.

To date, brentuximab vedotin for Hodgkin lymphoma and pembrolizumab for PDL1-positive non-small cell lung cancer (first-line) have been approved for routine commissioning following CDF evaluation, with ongoing re-appraisal of four further treatments.

Conclusion

Population-based, routinely collected cancer data provide real-world insights into patient outcomes, and can help inform commissioning decisions.