argyrotsipi/train-dataset huggingface dataset:
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Siobhain Ann McDonagh (Labour, Centre-left): I completely agree with my hon. Friend. I wish her constituent, David, all the best How can we withdraw a drug from the NHS that is working, especially when we are offering nothing in its place? It seems senseless to me, and it is truly devastating to those for whom it really matters. Of course, as my hon. Friend says, Kadcyla is just one drug that we need to look at. What will happen with other key breast cancer drugs now and in the future? I wish to consider just two more examples. Perjeta is currently available through the cancer drugs fund, but unlike Kadcyla it has not yet been re-appraised, although it will be soon. Perjeta is used for HER2 positive secondary breast cancer patients. In many ways it is even more effective than Kadcyla, as it enables women to live for an additional six months without their breast cancer progressing, and can extend life by an additional six months or more. However, because it is administered with two other drugs—Herceptin and Docetaxel—it would not be considered cost-effective under NICE standards even if the drug manufacturer gave it away for free The other drug is Palbociclib, which is used on women with hormone receptor positive and HER2 negative breast cancer. It is a new drug, which is being assessed for the first time by NICE. It is extremely effective and enables women to live for at least an additional 10 months without their breast cancer progressing. However, because women are living longer, robust overall survival data are not yet available. Perversely, that will count against it in the NICE appraisal. Overall survival data are given greater weight than progression-free survival in NICE appraisals, despite the fact that the outcome is the same—a longer, more enriched life We are seeing effective treatment after effective treatment being rejected or facing rejection by NICE. I want to know this: is it really right that we have a health service that plans to take away those lifelines? How is the decision to take away these life-extending drugs beneficial for people living with cancer, or for any of us who might one day need access to them? Who makes these decisions, and how can we be sure that they are the right ones We have a drug appraisal process, which is certainly valuable and necessary, but I question the factors that constitute that process. It is too easy to assume that the experts must automatically be right. The process is: numbers in, formula used, and then a yes or no answer. Let us not forget that we are talking about people’s lives. The lives of those affected and those for whom this decision is all too real are in the hands of a formula—the NICE appraisal process—and yet this life-changing formula has had little examination for many years. How many of us actually understand what factors are taken into account in these life-or-death decisions? The drug Palbociclib is proving so effective that, at present, it only has data on how long people are living without their breast cancer progressing.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Siobhain Ann McDonagh (Labour, Centre-left): I agree with my hon. Friend. It is amazing to think that, for this particular drug, it will take longer to get overall survival data because people are living longer without their cancer spreading. That obvious success is seen as a big disadvantage in the NICE appraisal system. The cost of Palbociclib will appear to be much higher in the NICE formula because overall survival data are given much more weight than progression-free survival. That seems illogical to me Consider also the criteria for determining end-of-life treatment. If a treatment is end-of-life, it is allowed double the quality-adjusted life year costings of other drugs. End-of-life is considered to be two years, but why not three? How have we ended up with such an arbitrary, fixed figure, especially when the figure in Scotland is three years? There is no cure for secondary breast cancer, but as people start to live longer it will place them at a disadvantage when accessing treatments, because it will be harder for those treatments to become approved, as they are no longer considered under the end-of-life criteria Therefore, how can the Minister be sure that the NICE process is still fit for purpose? Will she respond specifically on two suggestions: first, to review the weighting for progression-free survival when overall survival is not available because a treatment is so effective; and secondly, to change the criteria for end-of-life treatment to three years’ survival instead of two I want to return to the issue of off-patent treatments. In recent years there have been two private Members’ Bills on the topic, one of which was introduced by my hon. Friend the Member for Torfaen (Nick Thomas-Symonds). We heard many commitments from the then Minister for Life Sciences, but we have not yet seen any improvement in access, which is hugely disappointing. The Minister committed to establishing a working group to investigate what could be done to enable the routine use of such treatments. I believe that the working group is due to conclude its work next month and publish its report. Will the report introduce a clear pathway for off-patent treatments, and will the Minister write to me with the details of the pathway and state explicitly how it will work for bisphosphonate drugs for the prevention of secondary breast cancer Breast Cancer Now and others have been disappointed by the extremely patchy availability of this treatment for eligible women. As a result, it recently launched the "43p a day" campaign to highlight the low cost of the treatment and the fact that it would save over 1,000 lives every year in the UK if it was routinely available, not to mention millions of pounds for the NHS.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Siobhain Ann McDonagh (Labour, Centre-left): I thank the hon. Gentleman. He is very lucky to have a constituent as exceptional as Bonnie Fox, who has already been mentioned because of all her work As a result of Breast Cancer Now’s campaign, the Minister has said that clinical commissioning groups are responsible for commissioning the treatment for bisphosphonates. What contact has been made with CCGs on the use of this treatment in these circumstances? As I understand it, the treatment presents a challenge to existing commissioning arrangements because it does not fit squarely into either specialised services, which are commissioned by NHS England, or local commissioning by CCGs. Does the Minister agree that if we want genuine progress on the availability of this treatment, we cannot take the path of least resistance and just say, "It’s up to CCGs; CCGs are independent bodies and can make their own decisions." That is the "do nothing" option Treatments do not always fit into the neat categories that we create. This is an old treatment that requires a new approach. It requires our commissioning strategists at NHS England to make a considered decision about how to commission the treatment routinely. Will the Minister agree to meet Ian Dodge, the national director for commissioning strategy, to discuss this specific case with him and will she keep Members here today updated on those discussions? Will she also agree that it is indeed worrying that a treatment that could prevent over 1,000 women getting secondary breast cancer every year is not routinely available Finally—I think that everybody will be delighted that I am about to finish—I hope that the Minister will consider meeting some of the women affected by the decision on Kadcyla and the women from Breast Cancer Now who are here today. I would like to thank those women in the Public Gallery for coming here to show their support for this debate en masse. I wish every single one of them well. Access to life-enhancing and life-saving drugs should be a right in the UK, not a decision based on a lottery of access to private healthcare. I sincerely hope that NICE will reverse its decision and give every woman with secondary breast cancer their future back.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
James Dolan Cunningham (Labour, Centre-left): I agree, because it is not only about the drugs we are debating today; we have had problems before in relation to NICE. In answer to the question from the right hon. Member for New Forest West (Sir Desmond Swayne), I think that the Minister should look at the procedures and at NICE itself, because otherwise we will keep coming back to this issue time and again. The years I have spent listening to the same issues with different drugs is nobody’s business, to use an expression.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Mary Helen Creagh (Labour, Centre-left): The NICE framework works very well for mass drugs for the entire population or where a whole vaccination is going to work, but for very small numbers of people, such as the 1,200 women who really need this drug, I do not think it is as effective a process. There are two organisations in this negotiation, NICE and Roche, and we must not have Roche seeing its new drugs Perjeta and Kadcyla as a new cash cow as Herceptin goes off-patent in 2017-18. Women’s lives should not be treated as cash cows by this drugs company.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Sharon Hodgson (Labour, Centre-left): The hon. Gentleman is making a very valuable point. Does he agree that one way around this issue would be to have prescribing pharmacists who could give out medications such as those basic painkillers, without the need for the patient even to see their GP, which would also free up valuable GP time?
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Nicklaus Thomas-Symonds (Labour, Centre-left): I begin by thanking the Backbench Business Committee for selecting this very important topic for debate this afternoon. I pay tribute to my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for the passionate but very thoughtful way in which she introduced the debate. I endorse everything that she said. On the drug Kadcyla, she said, quite pithily, that, first, it works and, secondly, it has far fewer side effects than many other cancer drugs. I was also very proud to have backed the "43p a day" campaign that she mentioned I declare an interest as the chair of the all-party group on off-patent drugs and should also say that one of my first actions as a Member of this House in 2015 was to become a breast cancer ambassador. I was very proud to do that, as the person who inspired me to come into politics, my grandmother, died of the disease some years ago I was lucky enough in my early months in this House to be drawn in the ballot for a private Member’s Bill. I introduced the Off-patent Drugs Bill, and although it was talked out in quite controversial circumstances on 6 November 2015, I was none the less pleased after that to work on a cross-party basis to achieve legislative progress. I pay tribute to the hon. Members for Central Ayrshire (Dr Whitford), for Bury St Edmunds (Jo Churchill) and for Daventry (Chris Heaton-Harris), and to the former Minister for Life Sciences, the hon. Member for Mid Norfolk (George Freeman), for the work that was done in those months to make legislative changes which were incorporated in the Access to Medical Treatments (Innovation) Bill, which received Royal Assent in March last year I want to come to the pledges that were made on 29 January 2016 and how things have moved forward since. I say to the Minister that in setting out a number of questions about this matter, I do not necessarily expect them all to be answered in detail in her closing remarks. If there are aspects that she feels she cannot answer in detail, I would be grateful if she wrote to me about them after the debate On 29 January 2016, I and others in the House tabled a package of amendments to the Access to Medical Treatments (Innovation) Bill. Some were substantial and went into the Bill. Others were probing amendments designed to extract the promises that I have talked about. The then Minister for Life Sciences said: "Broadly, the intention of the package of amendments is to introduce off-label repurposed medicines in the Bill, and to put it four square at the heart of the agenda." That is precisely what we sought to do that day. He added: "I wholeheartedly supported the intention of his Bill and its predecessor, but not the mechanism. We now have a mechanism that will work"— we had spoken that day about the mechanism One of the amendments requested an action plan, but the Minister decided he did not want that on the face of the Bill. However, he said: "let me set out my commitment and that of the Government to pursuing this agenda with time and rigour." —[Official Report, 29 January 2016; Vol. 605, c. 543.]
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Rupa Asha Huq (Labour, Centre-left): I remember very well my hon. Friend’s Bill and the shameful way it was talked out by the professional filibusterers on the Government Benches. However, does he not agree that any action plan needs to look at these things in the round? It should look at the poor post-diagnosis support and information that patients get across other types of cancer, not just breast cancer. It should also look at the limited availability of the effective drugs we have talked about, which do not have side effects, and at the fact that drugs have been de-listed from the Cancer Drugs Fund.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Nicklaus Thomas-Symonds (Labour, Centre-left): I understand that a new policy is being put together by those in charge of the "British National Formulary", which will set out how they will get more off-label drugs into the formulary. Does my hon. Friend agree that the sooner that policy is available for us to see the better?
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Michael Joseph Patrick Kane (Labour, Centre-left): I congratulate my hon. Friend on doing so much work in this area since he came to Parliament. We can only hope that what he says is true; perhaps the Minister can give us more information on that point in her summing up The Prevent Breast Cancer research unit has more out-of-patent drugs under investigation for breast cancer prevention which may be even better for the future. As well as doing everything we can to extend the life of women with secondary breast cancer, we must do all we can to prevent breast cancer from occurring in the first place. As we all know, the adage is that prevention is better than cure. For those with secondary cancer, for whom cure is currently out of reach, many people will be striving to achieve that for the next generation At the moment, the system is standing in the way. A solution to make those drugs more widely available that would cost very little money indeed would be to ask NICE to list such drugs as approved for the new indication of prevention in the "British National Formulary"—following the evaluation of relevant clinical trials, of course—so that doctors can have confidence in prescribing them. The requirement to obtain a new Medicines and Healthcare Products Regulatory Agency licence for the new indication is expensive and impractical for repurposed medications, because they usually lack a sponsoring pharmaceutical company to champion the new use of the generic drug. I am sure the Minister would agree that such a small change would be transformative in the prevention of breast cancer. I hope that she will ask NICE to consider that change to the way in which drugs are listed in the "British National Formulary" to allow drugs that have been evaluated for a new purpose, such as prevention, to be listed as approved for that purpose When we lose someone prematurely to cancer, grief obviously follows. It has been my experience that when we lose someone to breast cancer, the grief is particularly poignant. Tonight, my thoughts and prayers will be with all my constituents who have either succumbed to the disease or are battling it, and with their families who carry the consequences. I lost my cousin Maura Kane to the disease, and my two friends Tom and Claire both lost their mothers to it. I stand in solidarity with my constituent and friend Sheila Higgins, who is battling this disease. She has been like a mother to me for the last two decades. Finally, my parliamentary assistant Suzanne Richards came back to work after Christmas with a clean bill of health. She was diagnosed with a virulent strain last year, but she had world-class treatment at the Wythenshawe and Christie hospitals. Today is her birthday, but it is a birthday that many of us feared she would never see—happy birthday, Suzanne.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Sharon Hodgson (Labour, Centre-left): 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?
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Thangam Elizabeth Rachel Debbonaire (Labour, Centre-left): 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.
Breast Cancer Drugs — House of Commons, 2017-01-26
Topic: Health
Siobhain Ann McDonagh (Labour, Centre-left): I thank all the Members who contributed to this debate and thank the Minister for her detailed response. Most importantly, I thank the women in the Public Gallery for coming here en masse to show their support for this debate. I wish every single one of them well, and I hope that they will join me for tea afterwards. Perhaps unconventionally, I also invite any hon. or right hon. Members here to join me and those women for tea to thank them for their campaigning efforts and to understand more about their case. I expressly invite Suzanne from the office of my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane)—there is a cake in the Pugin Room with her name on it. Happy birthday, Suzanne Question put and agreed to. Resolved, That this House notes the provisional decision not to provide the breast cancer drug Kadcyla for use in the NHS on 29 December 2016; and calls on the National Institute for Health and Care Excellence (NICE) and pharmaceutical company Roche to come together and re-assess this decision to ensure Kadcyla is kept available for patients, and consider how access to both innovative new breast cancer drugs and off-patent drugs used for breast cancer, such as bisphosphonates, can be improved.
New Partnership with the EU — House of Commons, 2017-01-17
Topic: Health
John Mann (Labour, Centre-left): EU procurement rules have led to the privatisation of parts of the health service, including part of the ambulance service in the east midlands. Will the Secretary of State guarantee that when these negotiations are concluded and put in front of Parliament, we will have the opportunity, if we so choose, to renationalise the entirety of the health service, and indeed the rail industry, without EU procurement rules getting in the way?
Toilet Facilities: People with Disabilities — House of Commons, 2017-01-17
Topic: Health
Nicholas Dakin (Labour, Centre-left): I congratulate my hon. Friend on securing this debate. One of my constituents, Lorna Fillingham, has long campaigned for Changing Places toilets in all hospitals and health centres. Does my hon. Friend believe this campaign should be given more legs?