Advanced cancer treatments are on the horizon, but is the NHS ready?
In a recent survey by Bryter, 79% of oncologists working in the UK agreed that the NHS will fall behind the health systems of other developed countries if it does not make financial provision for new treatments like immunotherapies and CAR-T. What’s more, while the impact of Brexit on the NHS is still uncertain, three-quarters (76%) of oncologists agree that Brexit is a significant worry in continuing to provide effective cancer services in the UK.
For years, chemotherapy and radiation therapy have been the standard of care for cancer treatment, and it has been widely acknowledged that more innovative treatments are desperately needed across a range of tumour types. As we move into the era of increasingly personalised medicines, immunotherapies are predicted by many to be the start of a move away from traditionally aggressive approaches, but only if we can afford them.
Immunotherapy works by harnessing the power of patient’s own immune system to recognise and destroy cancerous cells, and there is mounting evidence of remarkable responses even in those with advanced cancers and where other treatments have failed. Immunotherapies are believed to have the potential to transform the cancer treatment landscape; when we asked oncologists over half (56%) felt that the potential of immunotherapies has not been overhyped, with 48% also feeling this way about CAR-T therapies.
CAR T-cells, or Chimeric Antigen Receptor T-Cells, have recently been in the spotlight. This approach uses patient’s own T-cells, genetically modified to express a new receptor designed to recognise specific proteins on cancer cells. Impressive trial data has sparked a great deal of excitement for CAR-T, with the NHS taking steps to make these cutting-edge therapies available. Late last year it was announced that two types of CAR-T therapies would be offered to a select group of blood cancer patients in England. These ground-breaking treatments come at a considerable cost: around £280,000 per patient. Although the NHS has negotiated a discounted deal, these treatments are currently only an option for a fraction of patients. When it comes to making CAR-T therapies widely available three-quarters (76%) of oncologists in our survey agreed that this represents a serious financial challenge for the NHS.
In fact, the question of funding is a threat for all potential immunotherapies. This movement of cancer drugs that are increasingly personalised and complex are pricier as a result. It’s therefore not surprising that even as immunotherapies gain traction, 72% of oncologists in our survey felt that making these therapies widely available would be a serious financial challenge for the NHS.
It seems that high costs and future uncertainty may still put the NHS at risk of falling behind in approving and providing these types of treatments to patients here in the UK. As research into immunotherapies continues to grow, the NHS will have to confront this challenge, and find ways to continue embracing new and innovative technology. Not easy at a time of financial uncertainty and with the looming spectre of a possible no-deal Brexit.
Laurence Olding is Research Director at Bryter. Additional research by Georgina James.
Bryter interviewed a sample of 80 oncologists in the UK, in November-December 2018. Interviews were conducted online. Bryter is a market research agency, working for the world's top healthcare, technology, and telecommunications organisations.