Outcome-based payment for cancer drugs

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Recent years have seen real improvements in UK patients’ access to newly-launched cancer drugs. However, there remain regulatory and commercial challenges to ensuring patient access to new treatment options is as quick and comprehensive as possible.

Outcome-based payment (OBP) links a drug’s price to the outcomes it delivers for patients in the NHS, and could help improve patient access to evidence-based and cost-effective drugs. Cancer Research UK and Greater Manchester Health and Social Care Partnership are therefore jointly undertaking a multi-phase programme of research into the use of OBP in the NHS in England.

The study is expected to be conducted in three phases. The first phase of the research concluded with the publication in February 2019 of a research report based on original research undertaken by the Office of Health Economics, RAND Europe, and King’s College London, available to download from this page. 

The report found that wider use of OBP in the NHS is possible and desirable for some (but not all) new cancer drugs. It is best-suited to cases where substantial uncertainty remains about a drug’s effectiveness even after clinical trials data are available.

The report also investigated the treatment outcomes that matter most to patients and carers when receiving treatment with cancer medicines. Based on our findings, the report sets out an “outcomes framework” with four key outcomes: survival; disease progression, recurrence or relapse; long-term side effects; and return to normal activities.

We are now undertaking a second research phase, which will address key uncertainties and barriers to implementing OBP identified in the first phase report. It will focus on identifying patient outcomes data already available within the NHS, and the practicalities of collecting any additional data needed to administer an OBP scheme based on the outcomes framework from the first phase.

If taken forward, the study’s third phase will carry out a live pilot of an OBP scheme within Greater Manchester, based on the principles set out in the first phase report.

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