Policy roundtable: Will an interim fund fulfil the promise of novel oncology drugs?

Pharma News: Dr Mike Freelander MP, Chair, and Melissa McIntosh MP, Deputy Chair of the House of Representatives Standing Committee on Health, Aged Care and Sport, are spearheading an Interim Cancer Fund Policy Roundtable at Parliament House today.

The initiative, led by AstraZeneca, convenes over 30 oncology leaders and parliamentarians to deliberate on vital strategies aimed at addressing the pressing need for expedited access to life-saving treatments within the Australian healthcare landscape.

Currently, Australian patients endure an average wait of 442 days between the Therapeutic Goods Administration (TGA) approval of potential life-altering cancer medicines and their availability through the Pharmaceutical Benefits Scheme (PBS).

At the recent rare cancer’s inquiry, Penny George, Director of Corporate Affairs at AstraZeneca, called for an “earlier, faster, fairer approach to cancer care” and recommended three key policies to enhance access. These include the establishment of an interim cancer drugs fund, subsidising genetic profiling for all cancer patients upon diagnosis, and separating funding decisions between cancer treatments and diagnostic testing.

The UK, Italy, France and Germany have established a cancer drugs fund to provide investment for interim access to drugs that are not yet reimbursed through the normal pathways.

“The approach prioritises patient-centred principles, assessing both urgent and clinical needs in areas with immature data, such as rare cancers. It advocates for broad stakeholder collaboration among patients, patient associations, and the clinical community. The framework also looks at horizon-scanning to anticipate future developments in clinical trials,” Ms George added.

Despite the use of similar assessment criteria when deciding whether new cancer drugs should receive funding, there are substantial differences in drug funding decisions across comparable high-income countries, according to a recent study.

For example, of the best-selling cancer drugs across a variety of cancer types, Germany funded all of them; followed by Italy with 94%; Japan with 82%; then England, Canada, France and Australia with 79%. Finally, New Zealand funded 35%.

In a separate analysis looking at funding for cancer drugs determined to have marginal benefit by an independent body (European Society of Medical Oncology), Germany funded 83%; Japan 67%; France 50 percent; Italy 39%; Canada 28%; England and Australia 17%. New Zealand did not fund any cancer medicines with marginal benefit.

The proposed Green Paper prepared by AstraZeneca for today’s roundtable aims to catalyse a comprehensive consultation and evaluation process for an Interim Cancer Fund (ICF) tailored to the Australian context. Central to this is the establishment of a formal working group comprising governmental representatives, patient advocacy groups, clinicians, and industry stakeholders. This collaborative effort seeks to delineate critical aspects of the ICF framework, including funding mechanisms, criteria for access, and practical implementation within the existing healthcare system.

The envisioned Interim Cancer Fund would bridge the gap between TGA approval and PBS reimbursement, enabling patients to access life-saving treatments expeditiously while further economic data is gathered. For every dollar invested in cancer treatments in Australia, there is a return of $3.06 in social and economic value, highlighting the compelling case for investment in advanced health technologies.

“Whilst we are supportive of any ideas that help give patients access to medicines faster, interim funds are not the whole answer. A complex, innovative policy solution needs to be brought to the table,” said Christine Cockburn, CEO of Rare Cancers Australia.

Drawing inspiration from international models, the roundtable seeks to distil best practices and adapt them to the Australian context. The UK Cancer Drug Fund (CDF), launched in 2010 and updated in 2016, has facilitated earlier access to cancer treatments for over 21,300 patients.

Amid the ongoing deliberations, The New Frontiers Report noted the German CDF model and the need for a balanced approach that ensures accessibility, affordability, and transparency in cancer treatment provision.

“The system has faced fiscal challenges with some companies overpricing and failure of the system to clawback excess from use beyond indication, or failure to achieve health outcomes in real world application versus clinical trials,” the report said.

Leveraging Australia’s experience with risk-sharing arrangements and data accessibility through electronic health records, the proposed CDF aims to strike a delicate equilibrium to meet the evolving needs of cancer patients and healthcare providers alike.

Ben McDonald, Country President of AstraZeneca for Australia and New Zealand, told Health Industry Hub, “AstraZeneca believes an Interim Cancer Fund is the best way to provide faster and fairer access to new medicines, bridging the gap between TGA approval and PBS funding.”

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