Sharon Hodgson MP's report - Mar-Apr 2017 number 94
Click on picture above to read Sharon Hodgson MP's report - News from Westminster - Mar-Apr 2017 number 94
In her capacity as Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on Breast Cancer Drugs, specifically the drug, Kadcyla and other drugs used for treatment of breast cancer.
Image copyright BBC Parliament 2017
You can read Sharon's speech here: Breast Cancer Drugs Backbench Business Debate 26.01.17
Speech pasted below:
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I thank my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for securing this debate, following the very sad news that her friend Samantha Heath, who had been receiving this life-extending treatment, had heard from NICE that it was being taken away from her. I am pleased that she was able to secure this important debate through the Backbench Business Committee.
I also thank all colleagues who have attended the debate and made excellent speeches, sharing with us their experiences and thoughts, including the hon. Members for Milton Keynes South (Iain Stewart), for Portsmouth South (Mrs Drummond), for Louth and Horncastle (Victoria Atkins) and for Wycombe (Mr Baker), my hon. Friends the Members for Torfaen (Nick Thomas-Symonds) and for Wythenshawe and Sale East (Mike Kane) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who spoke for the SNP. I am sure that the Minister has been given lots to think about, and I look forward to her response shortly. I also thank Breast Cancer Now for its work campaigning on this matter, along with Breast Cancer Care for its continued dedication and its support and advocacy for individuals with secondary breast cancer.
In my contribution, I will first briefly establish the documented and perceived benefits of Kadcyla, and then, building on that, discuss the broader issues around the provision of off-patent drugs, before moving on to present the problems with determining the funding of a drug based principally on its cost-effectiveness as judged by NICE.
Kadcyla’s continued funding through the cancer drugs fund in 2015 was a great success for patients and patient advocates. At the time, the value of the drug was recognised and the concession was made that, despite its high cost, its positive impact was worth the funding it needed. Yet just over a year later, the alterations to the cancer drugs fund have prevented the future funding of this drug, along with, potentially, that of a number of other secondary breast cancer drugs such as palbociclib and Perjeta—I hope that I pronounced those correctly—as it moves towards becoming a funding mechanism for under-researched but innovative drugs with cost and value as a principal driver, and away from its original principle, which was to finance drugs that were too expensive to be recommended by NICE but proved effective in treating cancer patients.
We can all agree that patients have benefited significantly since the introduction of the cancer drugs fund, but the progress that has been made in recent years in improving access to cancer drugs is now at risk. That is unsurprising, given the cash-strapped state of the national health service—we have discussed that in the House recently in the past few weeks—which faces pressures to provide these costly drugs that are developed by large pharmaceutical companies, and is forced to consider costs rather than clinical need. I hope that the Minister will tell us whether those concerns have been assessed, and how she plans to address them. We have heard a number of good suggestions today about how funding may be redirected.
Mary Glindon (North Tyneside) (Lab)
Is not the situation made all the more poignant by the fact that since 2001, the incidence of breast cancer has been rising by 9% every year?
That is a very good point. It may be that more and more people are coming forward and being diagnosed, but, as my hon. Friend says, this will clearly become more of an issue, not less of an issue, in the years to come.
As we have heard today, it is estimated that Kadcyla benefits 1,200 women every year in England alone, and that on average it can increase the length of a woman’s life by six months, although reports suggest that in the case of some women that can stretch into years. Even if it is measured in months, however, the extra time is surely priceless to the women and families involved. I speak from personal experience, as I lost my mother-in-law to secondary breast cancer 20 years ago this year, when my children were very small. I know that she fought for every extra week and day in the end, and that she would have given anything for an extra six months to spend with her grandchildren. We all wanted that little bit longer for her. For all those 1,200 women, that extra time is time with their families. It means seeing their children reach perhaps one more milestone, starting school or university, getting married, or even giving them a grandchild. What is the cost of such moments, such memories, which are so precious and which help families so much with what, ultimately and inevitably, will follow?
The hon. Lady has made a powerful point. In the case of the most aggressive cancers, the period between diagnosis and death can be very short. As the hon. Lady says, any extension of life enabling women to celebrate family events, or anything else, is incredibly important, and we should not lose sight of that.
I agree. What price can be put on those precious months?
Thangam Debbonaire (Bristol West) (Lab)
I have some investment in this. My own experience of breast cancer treatment over the last two years has left me passionate about the issue of prevention and early diagnosis. Will my hon. Friend join me in not just thanking the breast cancer charities—as she has already done—but calling on all Members to spread the word among all the women they know that they must learn how to examine their breasts? I learnt how to do it from a comic sketch in a television programme: that is how I diagnosed my lump. I want everyone to learn how to do it, and also to learn what they can do to help prevent breast cancer, because, although there is no magic prevention method, there are ways of reducing the risk.
Although we have not so far touched on prevention or early diagnosis, they are vital issues. We have discussed them in the House on many occasions, but they can never be discussed too often, and I am grateful to my hon. Friend for raising them. Let me add that I am happy every day to see her back in this place, and doing so well.
What also stands out with Kadcyla is the reduced side effects, as we have heard, as opposed to alternative breast cancer treatments, the side effects of which can include the inducement of osteoporosis and an increased risk of blood clots. As some colleagues will, sadly, know first-hand or through experiences of family and friends or constituents, the side effects of some cancer treatments can be truly awful, and in some cases are daunting enough to prevent the acceptance of further treatment entirely. It is a common perception that women make the decision to end their treatment much earlier than planned, despite it prolonging their life sometimes. That is because they feel the suffering they are enduring as a result of the treatment is not worth the additional life it is providing to them, because it is all about the quality of that life.
Research conducted by Genentech in the United States on the side effects of Kadcyla found that less than 5% of women taking the treatment suffered any hair loss. Through my work as co-chair of the all-party group on breast cancer, I know that hair loss can be a highly traumatic experience for women undergoing cancer treatment and is one of the most discussed side effects of cancer treatment in general. Given that in this debate we are discussing the treatment of secondary breast cancer, which is ultimately a terminal disease, the best outcome we can offer through treatment is both the extension of life and the preservation of the quality of life enjoyed pre-diagnosis. Therefore, because Kadcyla causes fewer side effects, it represents a treatment that can effectively achieve not only an extension of life, but the preservation of some of that quality of life enjoyed by these women pre-diagnosis. So I look forward to hearing from the Minister about what she is doing to ensure women will benefit from this vital treatment in the future.
I will now move on to how we can better support off-patent drugs, especially for breast cancer. Drug patents typically last for 20 years—although sometimes only 10 years—and at the end of that patent there is very little incentive for the drugs to be licensed for use in another indication. These drugs are still clinically effective in many cases and can be a low-cost effective treatment, but currently the NHS has no method for making them routinely available.
Bisphosphonates are one such example of an off-patent drug that is not being made universally available to patients, despite evidence showing its effectiveness. It is estimated that, if given to the entire eligible population, this drug could prevent one in 10 breast cancer deaths. It is therefore concerning that research conducted by the UK Breast Cancer Group found that only 24% of breast cancer clinicians were offering bisphosphonates to patients. Solving this issue therefore provides an opportunity to improve breast cancer survival rates, and it is something that I hope the Minister will consider carefully.
I want to finish by discussing the cost-effectiveness of drugs. Currently NICE measures cost-effectiveness using quality-adjusted life years—QALY—and one QALY is equal to one year of life in perfect health. As I am sure colleagues will agree, it is almost impossible to objectively measure someone’s quality of life, and there are questions surrounding the morality of attempting to do so, as raised in NICE’s “Social value judgements” paper on the moral evaluation of drugs.
As is so often the case in these debates, a clear cause of the problem lies with how NICE approves drugs. At the last general election, Labour proposed a top-to-bottom reform of NICE, ensuring that drug acceptance and funding is determined solely by clinical need, not with cost or value considerations. This debate shows there is clearly a need to re-address these issues.
As I have already mentioned, Kadcyla patients tend to experience considerably fewer side effects, and this can potentially have a positive impact on their ability to enjoy a higher quality of life post-diagnosis. Because of practicality and cost implications, it is almost impossible for NICE to comprehensively and effectively measure this exact quality of life. However, what we can say, without a doubt, is that these individuals would suffer a lower quality of life without Kadcyla, and this, I believe, deserves more attention and value in the process of drug approval and funding.
The current funding of drugs is becoming based on the cost-effectiveness of a drug, rather than the clinical need, yet, as this debate has shown, it should not be the final deciding factor as it disregards very personal reasons for many people who rely upon drug treatments. Kadcyla has benefited many women during their time living with a terminal disease, and has now been pulled, devastatingly, out of their reach.
It is the Minister who has the levers of power to address the problems in the system which is letting these women down. Members from across this Chamber have eloquently made their case to the Minister. I hope she has listened—I am sure she has—and will give these women and their families some reassurances today.
Sharon has supported the call by the APPG on Cancer – of which she is a member – to address cancer survival rates in the UK, which are amongst the worst in Europe.
It is estimated that by 2020, almost half of the UK population will receive a cancer diagnosis during their lifetime.
Over the past year the percentage of people in England surviving at least one year from their initial cancer diagnosis has risen from 69.3% to 70.2%. However, this is still well behind comparable international rates – in Sweden, for example, one-year cancer survival is around 82%.
At the event, Sharon was presented with the cancer survival rates for Sunderland Clinical Commissioning Group which showed that 69% of local people with cancer will live for a year after diagnosis. This is lower than the national one-year survival rate for England of 70%.
Speaking at the event, Sharon said:
“During my time as a local Member of Parliament, I have worked hard on addressing cancer-related issues. This has included being chair of the Ovarian Cancer APPG and Co-Chair of the Breast Cancer APPG.
“One-year cancer survival rates have increased in Sunderland over the past few years, however, they still remain slightly below the national average. I have worked closely with Sunderland’s Clinical Commissioning Group on this matter, and will continue to do so in the coming years.
“All cancer patients deserve to be diagnosed as soon as possible to help address the costs to our NHS but also the cost to human life when diagnosis is too late to save a person’s life, that is why I will continue to work hard on this matter for my local constituents.”
Sharon Hodgson MPs report - Apr-May 2016 - number 85
Read Sharon Hodgson MP's report - News from Westminster - Apr-May 2016 - number 85
News from Westminster
Read Sharon Hodgson MP's report - News from Westminster - Feb-Mar 2016 - number 83
Welcome to my online monthly report - News from Westminster - which details some of the highlights from Westminster and the constituency.
As Co-Chair of the Breast Cancer APPG and Chair of the Ovarian Cancer APPG, Sharon attended an event in Parliament this week to show her support for World Cancer Day (February 4, 2016).
Sharon met with representatives from four of the UK’s leading cancer charities who are working together to unite the nation and help transform the lives of millions of people who are affected by cancer.
Cancer Research UK, Breast Cancer Care, Anthony Nolan and the Movember Foundation are calling on people across Sunderland to show their support by wearing a Unity Band with pride (February 4).
The Unity Band is made of two parts, knotted together, to represent strength in unity and the power of what can be achieved when people come together.
The Unity Bands are available from each charity in their own colours at www.worldcancerday.co.uk for a suggested donation of £2. All money raised from the Unity Bands will go towards the charities’ individual research projects and support services.
One in two people born in the UK will develop cancer at some point in their lifetime.
Collectively the four charities support millions of people every year through their individual work in the prevention, detection, treatment and support of those affected by cancer.
Money raised from the Unity Bands will fund breakthroughs in scientific research; save and improve the lives of people with blood cancers; provide high quality care, support and information for people with breast cancer, and fund research and support services to tackle prostate and testicular cancer.
By joining together this World Cancer Day, they aim to show that a small action taken by many will transform our future.
Reflecting on the message of World Cancer Day 2016, Sharon said:
“With World Cancer Day coming round this week it is important that people across the country, including here in Sunderland, show their support for helping to fight cancer – as we all do year round.
“Whether we spend this time celebrating those who have overcome cancer, showing our support for those currently undergoing treatment or remembering those who have sadly lost their life, it is important that we all come together and stand up against cancer and help reduce the devastating impact of cancer on future generations.”
For more information, to get any of the charities’ Unity Bands or make a donation visit www.worldcancerday.co.uk.
Read Sharon's latest Sunderland Echo column below or find the published column on the Sunderland Echo's website.
Cancer will sadly affect us all at one point in our life, may it be ourselves directly or a family member or friend.
That is why it is important that addressing cancer and improving services should always be at the top of any government’s agenda, as well as that of local NHS commissioners.
During my time as a Member of Parliament, I have campaigned for better access to treatment, screening and awareness of different cancers through my work as Chair of the All-Party Parliamentary Group for Ovarian Cancer and Co-Chair of the All-Party Parliamentary Group for Breast Cancer.
That is why I was concerned when news reached me that Sunderland Royal Hospital had ceased all breast cancer treatment services in the City.
This has meant women from Sunderland battling breast cancer now must travel further afield to places like Gateshead, Newcastle or Durham to receive their on-going treatment.
The reason given for the closure of this vital service by the Clinical Commissioning Group (CCG) and the Hospital was down to patient safety concerns after they were left with no consultants to lead the service and two breast cancer nurses left for new jobs at other hospitals.
I know that this is an issue that women in Sunderland who are battling breast cancer, or have won their fight, feel strongly about after the ‘Save Our Service’ group was created to put pressure on Sunderland’s CCG and Hospital to reinstate this important service.
As Sunderland is the largest urban authority in the North-East, I feel it is only right that women in Sunderland should have a local breast cancer service that they can rely upon.
I wrote to both the head of Sunderland’s Clinical Commissioning Group and chief executive of Sunderland Royal Hospital’s Board, and also met with the Minister for Cancer, to highlight my concerns for the future of this service.
It is now clear after pressure was put on the CCG and the Hospital, that the service will now be reinstated by April 2016.
I will work closely with the Save Our Service Group, my fellow Sunderland MPs, the Clinical Commissioning Group and Sunderland Royal Hospital, to make sure this service is reinstated when promised, so women here in Sunderland receive the best service possible when it comes to treating breast cancer.
Sharon Hodgson, MP for Washington and Sunderland West, has demonstrated her support for women with breast cancer by becoming a Parliamentary Ambassador for leading charity "Breast Cancer Now".