£100k-a-year cancer drugs ‘have little effect on life expectancy’ 

Expensive new cancer drugs are contributing little to the life expectancy of dying patients, an expert has warned. 

Despite billions of pounds of investment, most extend the lives of patients by a few months at best, according to analysis published in the British Medical Journal last night.

Dr Peter Wise, a retired consultant physician from Charing Cross Hospital in London, claims drug development has contributed little to the improvements in cancer life expectancy seen in recent decades.

The world’s biggest drug firms make huge sums from cancer drugs, with the most expensive treatments costing more than £100,000 a year.

Dr Peter Wise, a retired consultant physician from Charing Cross Hospital in London, pictured, claims drug development has contributed little to the improvements in cancer life expectancy

Global sales hit £85billion last year, and that figure is set to soar with one in two people born today expected to get the disease at some point.

Already more than 352,000 are diagnosed each year in the UK – a number expected to hit 500,000 a year by 2035.

Billions are invested in new drugs, yet the 48 new cancer treatments approved between 2002 and 2014 only lengthened life expectancy by an average 2.1 months, Dr Wise said.

Cancer charities are keen for new drugs to be funded – even with such marginal benefits – arguing that even a few months at the end of a life can give patients precious extra time with their families.

But Dr Wise insisted that allowing such drugs to be provided was questionable.

‘The approval of drugs with such small survival benefits raises ethical questions, including whether recipients are aware of the drugs’ limited benefits, whether the high cost:benefit ratios are justified, and whether trials are providing the right information,’ Dr Wise wrote.

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Chemotherapy drugs are only truly effective for 10 per cent of cancer patients affected by certain cancer types, including testicular, cervical and ovarian cancer, and lymphoma and Hodgkin’s disease, he said.

Citing a 2004 Australian and American study, he said of the remaining 90 per cent of patients, chemotherapy only increases five-year survival by 2.5 per cent – an average increase of just three months.

Yet most patients think these drugs can cure them, Dr Wise said.

‘In an important multicentre study, almost 75 per cent of 1,200 patients with metastatic colorectal and lung cancers considered it likely that their cancers would be cured by chemotherapy,’ he wrote.

‘Yet a cure in these situations is virtually unknown.’

‘Unawareness of poor treatment outcomes leads patients to only rarely question a physician’s proposal for chemotherapy.’

Dr Wise called for regulators to raise the bar for drug approval.

Global sales hit £85billion last year, and that figure is set to soar with one in two people born today expected to get the disease at some point

He said: ‘Spending a six-figure sum to prolong life by a few weeks or months is already unaffordable, and inappropriate for many of the 20 per cent of the Western population who will almost inevitably die from solid tumour metastases.

‘Above all, the efficacy bar for approval needs to be raised for both new and existing cancer drugs — by using more meaningful statistical and disease specific criteria of risk-benefit and cost-benefit.’

His assessment echoes that of the Academy of Medical Royal Colleges, which last month issued a list of 40 ‘unnecessary treatments’ that are of ‘little or no benefit’ to patients.

Chemotherapy for terminally-ill cancer patients was included on the list, with the Academy warning that it may ‘raise false hopes’ and will probably do ‘more harm than good.’

Many experts have warned that Britain’s cancer drugs bill is becoming unaffordable.

A major report by the Commons Public Accounts Committee last year warned that mismanagement of the £1.3billion Cancer Drugs Fund meant that patients dying of other diseases were missing out on cutting-edge drugs.

When it was founded in 2010, the Cancer Drugs Fund budget was capped at £175million a year, but this rose to £416million as demand grew.

The report said: ‘To help cover this overspend, NHS England had to defer some planned spending on primary care services.’

NICE – the NHS drugs rationing watchdog – has now taken control of the fund.

Dr Wise said he hoped it would be able to rein in spending.

‘NICE is highly cost aware, and it is to be hoped that a less permissive approval principle will evolve,’ he wrote.