1. Experience of Tyrosine-Kinase Inhibitors (TKI) for 1st line NSCLC
Dr Jill Gardiner, Consultant Medical Oncologist, Newcastle
&
Mr Steve Williamson, Consultant Pharmacist, NECN
April 2012
CONFIDENTIAL INFORMATION – DATA PROVIDED BY ASTRAZENECA UNDER LEGAL AGREEMENT

2. Review Of Gefitinib Use in NECN
In October 2010 NICE approved gefitinib (Iressa) for 1st line treatment of EGFR mutation +ve NSCLC patients
Gefitinib was approved by NICE with a Patient Access Scheme (PAS),
AstraZeneca, via its supply data, was able to analyse the use of gefitinib and use the information to demonstrate the uptake in the NHS.
NECN has worked with AZ have to review Network use and assess the value gained from the PAS scheme
The data only applies to NHS patients initiated via the AstraZeneca Single Payment Access (SPA) scheme.

3. Single Payment Access (SPA) Scheme
The SPA scheme is only available to the NHS for sourcing AstraZeneca Oncology Products.

4. Analysis Methodology
Note – this assessment measures “Duration of Treatment” – Not Progression Free Survival (PFS). As such, no clinical inference to the PFS benefit may be assumed.

5. Disclaimers & Assumptions
Background
Since September 2009, AstraZeneca has been providing Iressa®▼ (gefitinib) via
a Patient Access Scheme known as the Single Payment Access (SPA) scheme. The
scheme is DOH approved, and forms part of the NICE approval of gefitinib.*
Following a one-off charge at month 3 initiation, patients will be supplied
treatment until no longer required.
Objectives
This resource will help estimate the value of the SPA scheme, as well as
demonstrating the duration of treatment for NHS initiated patients at a national,
cancer network and trust level.
Methods
An economic model, based on the UK real life experience is used to estimate the
value of the SPA scheme and the effectiveness in those patients treated at
different geographic and NHS levels by using real world evidence data collected
as part of the SPA scheme.
Assumption
In this model the assumption has been made that one supplied pack is equivalent to
one month of treatment.

6. National Level Data
(For 2010 Initiated Patients)

7. Cancer Network Level – Gefitinib Use To Date
Cancer Network: North of England
Year
2009
2010
2011
2012*
New patients inititated 15 23 7
* 2012 is until the end of March 2012
Cancer Network
PURCHASERS
Grand Total
North of England
Queen Elizabeth Hospital 6
James Cook University Hospital 7
North Tyneside General Hospital (Northumbria) 9
University Hosp of Hartlepool 5
University Hospital Nth Durham
Freeman Hospital
Darlington Memorial Hospital 3
North Cumberland Infirmary 1
Cumberland Infirmary
South Tyneside District Hospital 45

8. Cancer Network Level – Analysis (2010 Initiated Pt’s)

9. Note this data applies to patients started in 2010
TRUST LEVEL DATA
DISCLAIMER
Note this data applies to patients started in 2010
Further data sets on 2011 & 2012 patients awaited from AZ

13. ERROR WITH DATA – TO UPDATE

19. In Conclusion Re Iressa Scheme
AZ believe at a national level, Gefitinib is over delivering vs. expectation to justify price set in relation to NICE approval
At a NECN level gefitinib is meeting the NICE & clinical evidence expected durations of use
At a Trust level experience is low however....
Overall.... Scheme appears to deliver value, average number of packs patient = 9.4 ……? 9.4 months PFS
But confirmation via clinical audit needed….