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Systemic Anti-Cancer Therapies (SACT) and Acute Oncology Service (AOS) Education Event, Llandudno, UK
Introduction
Effective horizon scanning plays a key role in ensuring patients have timely access to medicines. This requires knowledge of what is in the pharmaceutical pipeline as well as the potential impact of those
medicines on budgets and services. Engagement with all relevant stakeholders is key to understanding the potential impact of new medicines, including medicines associated with a biomarker test. AWTTC and the Wales Cancer Network recognised that as part of the existing horizon scanning process, the original secure platform utilised for sharing information resulted in engagement barriers. AWTTC
collaborated with the Wales Cancer Network with the aim to improve engagement with key stakeholders and develop a 'Once for Wales' approach to horizon scanning for new cancer medicines.
Process
The Systemic Anti-Cancer Therapies (SACT) Horizon Scanning Collaborative Group was convened and met for the first time in December 2023. This group continue to meet monthly and has representation from AWTTC, the Wales Cancer Network SACT team (at least one pharmacist for each cancer site speciality), the All Wales Genomics Oncology Group, the All Wales Medical Genomics Service and the National Pathology Programme. AWTTC uses a new secure platform to share a list of medicines with the potential for a NICE or AWMSG recommendation within the current and following financial year. Access to the platform is given on receipt of a completed confidentiality agreement. Each month the group reviews a selected list of medicines identified by AWTTC and rate them as red, amber or green depending on the anticipated budget and/or service impact. A new medicine or indication is regarded as ‘high impact’ (red rating) if it has a predicted net budget impact of greater than £1,000,000 per annum in Wales or is associated with major service implications such as large patient numbers, extended clinic time, significant adverse effects, or new biomarker testing requirements.
Outcomes
In the first six months the new group discussed 103 medicines. Of these, 27 were given a red rating. The revised process has given the Wales Cancer Network, Cancer Site Groups and laboratory services advanced notice of these medicines and led to earlier discussions around service delivery, including genomics and pathology services. It has enabled the group to notify other services, such as aseptic units and ophthalmology, of the need for their input to the delivery of forthcoming medicines. It
has also highlighted the need to develop new all Wales guidance for particular therapy areas, e.g. bispecific antibody treatments where intensive care management for serious adverse effects may be required.
Conclusion
The AWTTC horizon scanning team and the Wales Cancer Network SACT team have established a new group to facilitate horizon scanning on a 'Once for Wales' basis. This collaboration will avoid duplication of work by individual health boards/trusts and provide key stakeholders with information to enable timely service planning. The next steps will be to review the process after it has been in progress for 12 months.
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