21 May 2018

Senior haematologists have called NHS England to reverse restrictions on using ibrutinib to treat relapsed chronic lymphocytic leukaemia.

NHS England has been accused of over-riding guidance from the National Institute for Health and Care Excellence and introducing its own criteria for the use of the drug.

Writing to The Times today, 13 doctors from the UK CLL Forum say that NHS England’s position makes “no sense at all” and must be reversed.

The restrictions are forcing consultants to reuse chemotherapy when it may be “clinically inappropriate”, posing extra risks to patients they warn.

They have been angered by an NHS England decision that the drug should not be available to patients who have been in remission for three years or more.

Signatories of the letter include Professor Peter Hillmen, of Leeds University, Professor Anna Schuh, of Oxford University, and Dr Adrian Bloor, of the Christie Hospital, Manchester.

They say that NHS England’s decision has been made in a “closed process” with no input from patients or experts. This was in contrast with NICE, which undertakes extensive consultation before making recommendations.

David Innes, chair of the CLL Support Association, has also written to Health Secretary Jeremy Hunt calling for an urgent meeting.

He says the restrictions do not apply in Wales or Scotland, creating a “cross-border post-code lottery unfairly penalising English patients.”

An NHS England spokesman said: “The NICE recommendation was based on evidence about a group of patients for whom further treatment with chemo immunotherapy was not a good option. This did not include patients who had been in remission for more than three years where a further course of chemo immunotherapy would be considered the clinically appropriate treatment.

“Should a patient fail to respond to this, ibrutinib would then be an option.”

Sources: The Times/ CLL Support Association


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