Cancer Vanguard
Why a medicines optimisation workstream
Cancer Vanguard
What we have achieved in Year 1
4th May 2016:
Chief pharmacists
meet to discuss
“Pharma Challenge”
May 16’
17th May 2016:
Engagement with
ABPI & EMIG
June 16’
24th June 2016:
39 responses received
from Industry
July 16’
5th July 2016:
Evaluation event
undertaken and a shortlist
of projects was compiled to
be developed further as
part of the Cancer
Vanguard
24th July 2016:
Kick off meetings with
successful companies
to start drafting PID
Aug 16’
23rd August 2016:
Second evaluation
event and more projects
shortlisted
Sept 16’
21st September
2016: First Joint
MO Group meeting
and ratification of 2
PIDs
Nov 16’
November 2016:
Signing Joint
Working
Agreements -
Sandoz & 1st
Amgen project
Dec 16’
December
2016:
Ratified PID
with
QuintilesIMS
and Celgene.
Cancer Vanguard
What we have achieved so far…….
Amgen (Denosumab) – Breast (UCLH leading)
Contribute to and share evaluation of service modelling outcomes
Taking delivery of care out of the hospital setting
QuintilesIMS – Metastatic Colorectal (GM Leading)
Identify avoidable variation in m-Colorectal pathway
Pilot and evaluate a patient App. (U-Motiff) PROMS and PREMS
Model potential savings when variance is reduced
Testing the model of combining macro-data sets from across multiple
sites
Celgene. (GM leading)
Presenting SACT data in a user-friendly format to clinicians to identify
possible areas for improvement.
Cancer Vanguard
What we have achieved so far…….
BMS (UCLH leading)
Adverse event monitoring of patients undergoing immuno-oncology
therapies.
Amgen (UCLH leading)
Developing models of care for the home delivery of SACT.
Sandoz. Biosimilars.(RMH leading)
Cancer Vanguard
Denosumab Toolkit
Background
• London Cancer Breast Pathway Board and Chemotherapy ERG project to enable equity of access to
patients in the ICS.
• Work undertaken with commissioners and clinicians.
Cancer Vanguard
Amgen NHS
Interviews with key stakeholders to
identify all potential options via Quintiles
IMS and project management support.
Engagement of stakeholders from all
Vanguard sites and commissioners.
Hosting workshop
PPI involvement
Development of costing tool applicable
to all similar treatments via Quintiles
IMS.
Health economist support in ratification.
Weekly teleconferences, project
management and clinical support at all
stages
Development of a toolkit via Quintiles
medical writers, provision of national
case reports.
Creation of template, guidance on
development of document. Appropriate
dissemination.
UCLH – Amgen Joint working
Cancer Vanguard
Updated Front Screen
Cancer Vanguard Cost Input Screen
Cancer Vanguard
Lessons Learnt
• Project management support essential
• Clinical and commissioner engagement from outset
• Project completion and dissemination planned April 2016.
Cancer Vanguard
Biosimilars in Cancer
• First one (Biosimilar Rituximab) due end of March
• Sandoz proposed a non product specific approach
• Learning from previous uptake of Biosimilars
• Structured approach to include:
– Educational material to increase awareness
– Support for local policy implementation
– Patient Information
– Position statements from multi-professional groups
• BOPA, BSH, National Lymphoma Groups, NHSE Specialist
commissioning, UKMI, National procurement groups
Cancer Vanguard
Biosimilars in Cancer – material.
Aim to do once and share….
Cancer Vanguard
Why has this Collaboration worked?
• Overall help in improving access to cancer medicines
• Timing was right
• Strong existing pharmacy network
• Potential to make significant impact and efficiencies
• Didn’t wait to be asked coupled with ‘can-do’ approach
• Able to move at pace…..
• Multi professional engagement with interest in the project
• The models we are developing will both improve patient outcomes and generate
significant efficiencies:
• Spend on Rituximab in 2016 on all formulations : approx : £186.7m
Approx: 70% of this spend in Cancer
Cancer Vanguard
Specific Learning….
• Collaboration between all sites of the Vanguard exploiting:
both our scale (larger population than we would have had access to locally,
so of more interest to respondents).
our combined expertise to develop multiple, different new models from one
call
• Pace of change possible due to interest generated by the Pharma Challenge
• We always planned to share nationally:
Replicability of both the process and the new models developed meant
significant the country wide impact
Cancer Vanguard
Cancer Vanguard Medicines Optimisation Group
Chair
Rob Duncombe, Chief Pharmacist, The Christie
Deputy Chairs
Jatinder Harchowal, Chief Pharmacist & Clinical Director, The Royal Marsden
Rob Urquhart, Chief Pharmacist & Divisional Clinical Director, UCLH
Group Members Jenny Scott, Programme Director, GM Cancer Vanguard (The Christie)
Kate Farrow, Programme Manager, UCLH Cancer Collaborative
Sarah Clarke, Divisional Manager, Royal Marsden
Dr Ciara O’Brien, Clinical Fellow, Medical Oncology, The Christie
Alison Hill, Lead Cancer Nurse, UCLH
Victoria Grandage, Consultant Haematologist , Paeds, UCLH
Matt Backler, Associate Director Financial Strategy, Royal Marsden
Steve Scott, Head of Informatics, RM Partners
Greg Stringer, Communications, GM Cancer Vanguard
Secretariat Sue Whitworth, GM Cancer Vanguard (The Christie)
Additional support for London meetings: Tim Bill, RM Partners
Cancer Vanguard
Questions
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