Off-label treatments are often used in patients with rare cancers, as there are few licensed products for these specific cancers. Instead, the treatments prescribed are licensed for common cancer areas, but where the cancers have a similar underlying disease process. However, since the treatments necessary are not licensed for this use, patients must apply to their NHS trust to obtain them.
The report, Off limits - an investigation into NHS organisations’ policies and processes for determining requests for the use of off-label treatments for people with cancer, found that the opinion of trusts towards this form of prescribing, known as ‘near-label prescribing’, varies widely. It found that over the past three years, over 3,000 patients have applied to their Primary Care Trust (PCT) for funding for off-label treatments, and more than 1,000 have had their requests rejected. The study also assessed that patients with rare cancers in the UK are less likely to have access to off-label treatments than in France and Germany.
The report makes 25 recommendations for improvements, including:
- Near-label cancer treatments should be funded at the national level;
- Mandatory guidance should be issued to the NHS on the near-label treatments used most frequently; and
- The pharmaceutical industry should contribute to the costs of running the new system, provided that patients with rarer cancers benefit from improved access to medicines.
Further reading - A detailed review of the UK pharmaceutical market is available from Espicom: The Pharmaceutical Market: United Kingdom (published June 2009)