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