Medical experts are slamming a decision by NHS cost regulators that restricts use of Ariad’s Iclusig in the treatment of chronic myeloid leukaemia in England while patients in Scotland and Wales get full access to the novel drug. 

Iclusig (ponatinib) was cleared in Europe in 2013 as an orphan drug considered to offer a significant benefit to patients. However, it was not appraised by the National Institute for Health and Care Excellence because of its small target population, leaving the decision on access with the Cancer Drugs Fund, which says it can only be given to patients with the rare T315I mutation, representing about 2%-20% of CML patients.  

Results of a poll by the National Cancer Research Institute CML Working Group revealed that 83% of respondents support a change in CDF policy so that Iclusig is available to all appropriate patients in England in line with its approved indication, as the current disparity in access and use of treatments is failing patients.

“The CDF uses a different methodology to score therapies; by assessing the Median Total Drug Cost per Patient this effectively penalises therapies that help patients live longer,” said Mark Tanner, General Manager of ARIAD Pharma UK. “Given recent news about the restructuring of the CDF & NICE, we hope that NHS England will address this anomaly and quickly find a mechanism to allow patients in urgent need the same level of access as their neighbours in Scotland and Wales,” he added.

“Treatments should be available on an equal basis to all people with chronic phase CML across the UK; the decision should be medical, not geographical,” added Prof Mhairi Copland, Chair of NCRI CML Working Group and Professor of Translational Haematology, University of Glasgow, while Dragana Milojkovic, Department of Haematology, Imperial College School of Medicine Hammersmith Hospital, London, noted that “restricted use of therapies imposed by the CDF have seriously limited our ability to treat patients effectively, which is a barrier especially when treatments are used according to their full license elsewhere”.