The Cancer Vanguard and Amgen have developed a simulation modelling tool to show health commissioners and trusts the financial benefits and challenges of delivering breast cancer medicines in a variety of community settings.

Amgen’s Xgeva (denosumab) is used to help prevent serious bone problems in patients with bone metastases from breast cancer, and is commonly given to patients in chemotherapy units in hospitals even after chemotherapy treatment has been completed.

According to the partners, out-of-hospital delivery is an attractive proposition as it allows patients to receive care closer to their homes, potentially improving their overall experience of treatment, and also benefits trusts by relieving pressure on oncology services and freeing up staff and resources.

Health organisations can use the new simulation model to explore a range of delivery methods for Xgeva that take into account patient experience and cost implications, to help commissioners better appreciate the advantages and disadvantages, while a supplementary options appraisal document will enable organisations to understand the non-financial barriers and facilitators to implementation of out-of-hospital treatment.

“Throughout this process, we have found that being able to overcome some of the system-wide barriers to implementing new models of care is crucial to our success in improving the delivery of cancer medicines, such as denosumab, to patients,” said Dr Robert Urquhart, head of Pharmacy and Divisional Clinical Director at University College London Hospitals.

The Xgeva model “will facilitate others in developing their own ways of delivering cancer medicines closer to home, for patients that wish to participate.”

The toolkit is the result of a collaboration that began with the launch of the ‘Pharma Challenge’, an innovative process by which commercial companies were invited to ‘pitch’ project ideas to improve the provision of cancer medicines, to be developed jointly with the Cancer Vanguard.

The Cancer Vanguard programme, part of the NHS new care models programme, was set up in 2015 to assess and fast-track innovative methods of delivering cancer services in London and Greater Manchester, developing transformational new models of care that can be replicated nationally.

The programme is led by The Christie NHS Foundation Trust and the wider system of cancer services in Greater Manchester, The Royal Marsden NHS Foundation Trust, and University College London Hospitals NHS Foundation Trust. The three hospital trusts' spend on cancer medicines alone exceeds £120 million annually.