Government Response

The Government responded to this petition on Thursday 21st July 2022

Although NICE has not recommended bevacizumab for colorectal cancer, it has recommended a number of other medicines to treat colorectal cancer that are routinely available to NHS patients.

We are very sorry to learn about anyone who has been diagnosed with colorectal cancer. We know that a diagnosis can be devastating news to individuals and we recognise the immense challenges faced by them, their loved ones and friends following diagnosis.

The Government understands how important it is for NHS patients to have access to the most effective and innovative cancer treatments. It is also important that we have a system in place for making evidence-based decisions on which medicines should be routinely funded by the NHS to ensure the most efficient use of NHS resources, and that every pound spent on healthcare goes towards paying for medicines hospitals, doctors and nurses.

In England, the National Institute for Health and Care Excellence (NICE) makes evidence-based recommendations for the NHS on whether new licensed medicines represent a clinical and cost-effective use of resources. NICE is a world-leader in the development of evidence-based guidance, and plays a crucial role in securing rapid access to the most clinically and cost-effective treatments for NHS patients.
Where NICE recommends a medicine, NHS commissioners are legally required to make funding routinely available so that clinicians can offer it to their patients. Many thousands of patients have benefitted from access to new medicines as a result of NICE’s important work.

In 2012, NICE appraised bevacizumab (Avastin) for use in the treatment of metastatic colorectal cancer. After assessing the available evidence, it was unable to recommend bevacizumab as a clinically and cost-effective use of NHS resources. It is therefore not routinely funded on the NHS in England. However, NICE maintains surveillance of new evidence that may affect its published guidance, including cost considerations, and will consult on proposed changes with a wide range of stakeholders if any significant new evidence were to emerge. If patients or clinicians believe there is significant new evidence, they should contact NICE.

NICE has been able to recommend a number of medicines for the treatment of colorectal cancer that are now routinely available to NHS patients, including through the Cancer Drugs Fund (CDF). Some of these medicines include nivolumab in combination with ipilimumab, encorafenib, cetuximab and panitumumab. The CDF provides access to NHS patients to the most promising new cancer drugs where there is uncertainty about their effectiveness. Where NICE recommends a cancer drug for use in the CDF it is available to NHS patients through the CDF for a defined period of time, normally 2 years, while further evidence is collected on its use that will inform a later NICE appraisal.

Since October 2016, the CDF has benefited over 80,000 patients in England, providing them with life-extending cancer drugs that would not otherwise have been available to them. This year £340 million has been invested in the Fund, helping to provide faster access to the most promising new cancer drugs and ensure better value for taxpayers and the NHS.

Where a treatment is not routinely funded by the NHS in England, a clinician can, on behalf of their patient, make an application for extended funding of that treatment to the relevant commissioner. This is known as an Individual Funding Request (IFR). In making an application for an IFR, the clinician must demonstrate the exceptional circumstances of the patient that justifies the request for an IFR. For example, an IFR may be justified if the patient better responds to the requested treatment compared to other treatments, or if the patient responds better than would be expected to the requested treatment, and is therefore likely to derive greater benefit from the requested treatment.

Department of Health and Social Care