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993365

	registered interest
	date	22/10/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Haematological Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government (1) how many drugs were available on the NHS for the treatment of blood cancer, and (2) how much the NHS spent on blood cancer drugs, in each of the past five years.
	tabling member printed	Lord Mendelsohn
	uin	HL10893
	answer	answer is ministerial correction date of answer 05/11/2018 answer text <p>NHS England has advised that it is not possible to provide a comprehensive list of drugs that are available specifically for blood cancer or how much the National Health Service spends on blood cancer drugs as cancer drugs are often licenced for multiple different types of cancer.</p> answering member printed Lord O'Shaughnessy question first answered 05/11/2018 14:29:39 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

922991

	registered interest
	date	12/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Leukaemia: Ibrutinib
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government (1) what evidence NHS England considered, (2) which clinicians it consulted, and (3) which patient groups it consulted when deciding that ibrutinib should not be prescribed to people with chronic lymphocytic leukaemia who have been in remission for more than three years.
	tabling member printed	Lord Mendelsohn
	uin	HL8564
	answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8562 HL8563 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

922989

	registered interest
	date	12/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	NHS: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how NHS England formulates approval criteria for drugs already approved by the National Institute for Health and Clinical Excellence; and how it involves (1) patients, and (2) clinicians in this process.
	tabling member printed	Lord Mendelsohn
	uin	HL8562
	answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8563 HL8564 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

922990

	registered interest
	date	12/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Haematological Cancer
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how many Individual Funding Requests have been submitted to the NHS for the treatment of blood cancer; and of those, how many requests were (1) successful, and (2) unsuccessful.
	tabling member printed	Lord Mendelsohn
	uin	HL8563
	answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England has advised that it develops treatment criteria for cancer and other high cost drugs to support implementation of National Institute for Health and Care Excellence (NICE) guidance and to ensure approved treatments are available as intended, with access funded consistently across the country. These criteria are developed by relevant expert clinical advisers, drawn from NHS England’s 42 Clinical Reference Groups (CRGs). These CRGs have been established to support clinical commissioning across the entire specialised commissioning portfolio.</p><p>In the case of NICE Technology Appraisal TA429 for ibrutinib in previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation, NICE issued the following statement on 8 June 2018:</p><p><strong> </strong>“Given the evidence that was considered by the NICE appraisal committee, we consider it reasonable for the guidance to be read as referring to those patients considered unsuitable for retreatment. Because unsuitability for retreatment is not defined in the guidance, we consider it appropriate for NHS England, as the commissioner, to take clinical advice in order to do so.”</p><p>NHS England took clinical advice in setting the specific treatment criteria linked to this appraisal and we are advised that the criteria were derived from the main study that had underpinned the NICE guidance and are consistent with guidance issued by the European Society for Medical Oncology last updated in June 2017. Between January 2017 and May 2018, nearly 1,000 patients were registered to receive treatment with ibrutinib in this indication. This is in line with NICE’s estimates that 700 adults per year would be eligible for treatment as a result of its guidance.</p><p>However, NHS England has further advised that it is more than willing to receive and review by the end of July, any further evidence that patients and clinicians wish to submit on this matter. The evidence will first be considered by NHS England’s Chemotherapy CRG, with advice and recommendations from this group then being submitted to the National Medical Director, Professor Steve Powis, for consideration.</p><p>During 2017/18, 1,193 Individual Funding Requests were considered by NHS England. An analysis of how may related to treatments for blood cancer has not been conducted.</p><p> </p> answering member printed Lord O'Shaughnessy grouped question UIN HL8561 HL8562 HL8564 question first answered 26/06/2018 12:13:53 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

940091

	registered interest
	date	12/07/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Medical Treatments
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government how they review treatment criteria; and in how many cases treatment criteria have been amended since their implementation.
	tabling member printed	Lord Mendelsohn
	uin	HL9506
	answer	answer is ministerial correction date of answer 25/07/2018 answer text <p>NHS England is responsible for the processes it uses to translate recommendations by the National Institute for Health and Care Excellence (NICE) into its treatment criteria. NHS England’s treatment criteria are under constant review and are amended as appropriate to reflect feedback from stakeholders including clinicians, companies, licensing agencies and NICE and to reflect changes to NHS England policies. Given that its treatment criteria are reviewed on an ongoing basis, NHS England is unable to provide the number of cases where the treatment criteria have been amended since their implementation.</p> answering member printed Lord O'Shaughnessy question first answered 25/07/2018 11:05:14 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

1005631

	registered interest
	date	12/11/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Haematological Cancer
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of the level of spending on treatment for and research into blood cancer in other countries compared to the UK.
	tabling member printed	Lord Mendelsohn
	uin	HL11402
	answer	answer is ministerial correction date of answer 26/11/2018 answer text <p>NHS England does not hold information on the level of spending on blood cancer treatment in other countries.</p> answering member printed Lord O'Shaughnessy question first answered 26/11/2018 13:00:38 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

922992

	registered interest
	date	12/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Cancer: Clinical Reference Groups
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what assessment they have made of the transparency of the decision-making process of NHS England in relation to cancer clinical reference groups and the frequency with which such groups meet.
	tabling member printed	Lord Mendelsohn
	uin	HL8565
	answer	answer is ministerial correction date of answer 26/06/2018 answer text <p>NHS England’s current model of Clinical Reference Groups (CRG) was established following an extensive public engagement process which was completed during April 2016.</p><p>Since April 2016, the Cancer National Programme of Care has been supported by five CRGs (Chemotherapy, Radiotherapy, Specialised Cancer Surgery, Specialised Cancer Diagnostics and Children’s and Young People’s Cancer Services). The role of each CRG is to provide the primary source of clinical advice and leadership to NHS England on those services that are nationally commissioned. Each CRG comprises clinicians, patient and public voice representatives, professional association representation, public health experts and a commissioner and will usually meet between two and four times per year.</p><p>Transparency of decision making is important to NHS England. As a result, both stakeholder testing and public consultation are conducted regularly, in accordance with NHS England’s published Service Development Policy and Methods, in relation to the development of new clinical commissioning policy and service specifications.</p> answering member printed Lord O'Shaughnessy question first answered 26/06/2018 12:17:33 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

916588

	registered interest
	date	04/06/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Leukaemia: Ibrutinib
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what estimate NHS England has made of the number of people with relapsed or refractory chronic lymphocytic leukaemia who will not receive ibrutinib as a result of the treatment’s Blueteq Approval Criteria published on the National Cancer Drugs Fund List.
	tabling member printed	Lord Mendelsohn
	uin	HL8294
	answer	answer is ministerial correction date of answer 12/06/2018 answer text <p>An estimate of the number of patients with chronic lymphocytic leukaemia who will not receive treatment is not available. NHS England has advised that 828 patients with chronic lymphocytic leukaemia were registered to receive ibrutinib in 2017/18.</p> answering member printed Lord O'Shaughnessy question first answered 12/06/2018 10:51:00 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

993366

	registered interest
	date	22/10/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Haematological Cancer: Drugs
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what is the current level of spending by the NHS on blood cancer treatment; and what estimate they have made of the proportion of the NHS budget that will be spent on blood cancer treatments in each of the next five years.
	tabling member printed	Lord Mendelsohn
	uin	HL10894
	answer	answer is ministerial correction date of answer 05/11/2018 answer text <p>NHS England is unable to provide current or previous spend on drugs specifically for blood cancer as many of these drugs have multiple indications. For the same reason it is not possible to estimate future spend.</p> answering member printed Lord O'Shaughnessy question first answered 05/11/2018 13:36:52 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn

993367

	registered interest
	date	22/10/2018
	answering body	Department of Health and Social Care
	answering dept id	17
	answering dept short name	Health and Social Care
	answering dept sort name	Health and Social Care
	hansard heading	Medical Treatments
	house id	2
	legislature	25277 pref label House of Lords
	question text	To ask Her Majesty's Government what plans they have to consult on proposals to incorporate input from NHS England into the NICE technology appraisal process when determining treatment criteria.
	tabling member printed	Lord Mendelsohn
	uin	HL10895
	answer	answer is ministerial correction date of answer 05/11/2018 answer text <p>The National Institute for Health and Care Excellence (NICE) is an independent body and is responsible for determining the processes it uses in the development of its guidance.</p><p>NICE has advised that it has no plans to consult on changes to its processes as it has been able to use its existing structures to ensure NHS England’s intended commissioning criteria are included within the appraisal process. NICE’s existing technology appraisal process that was updated in April 2018 already allows input from NHS England at various points.</p><p>Patient groups that are registered stakeholders participating in each technology appraisal will be able to provide their views on NHS England’s proposed commissioning criteria as part of the technical engagement step. Where applicable, all patient groups and individual patients have the opportunity to comment during consultation on an appraisal consultation document.</p> answering member printed Lord O'Shaughnessy grouped question UIN HL10896 question first answered 05/11/2018 15:13:35 answering member 4545 label Biography information for Lord O'Shaughnessy
	tabling member	4286 label Biography information for Lord Mendelsohn