APPENDIX 59
Letter to the Chairman of the Committee
from Dr Ian Smith, Professor of Cancer Medicine and Medical Director,
The Royal Marsden NHS Trust
It was a pleasure to welcome you and your Committee
to the Institute of Cancer Research/Royal Marsden Hospital recently.
You asked me specifically about my thoughts on funding for phase
3 trials in the UK and potential costs. Since then I have spent
time discussing the issue widely with my colleages in clinical
cancer research. The key points are as follows.
— My own view, shared by many of my
colleagues, is that the UKCCCR represents the most appropriate
structure to prioritise and direct national Phase 3 trials.
— This is because the UKCCCR has 14
site specific Cancer Clinical Network Groups. Each of these provides
multi-disiciplinary leadership and appropriates specialist expertise.
— The UKCCCR as you will know is jointly
funded by the CRC, ICRF, LRF and the MRC; it also has associate
members and observers from key groups including the Department
of Health.
— Currently the UKCCCR receives around
£1.4 million per annum specifically allocated for trial development
and this comes jointly from the CRF, the ICRF, the MRC and the
Department of Health.
— This doesn't begin to cover the costs
of actually running the trials; therefore despite all its expertise
the UKCCCR has no teeth.
— I have written round to the chairmen
of the 14 site specific groups. In general each of these would
envisage running somewhere between 2-5 national Phase 3 trials
at any one time. Obviously there is considerable variation here;
the Breast Group would wish to run more trials than the Testicular
Cancer Group etc.
— The cost of trials varies greatly
depending on the size of the trial and the complexity of the question
being asked. The figure of around £250K per annum does however
seem to emerge as a starting point to cover the basic running
of the trial (data collection, analysis of results etc.) and also
the additional NHS costs operating through the Partnership Agreement.
This estimate makes the reasonable assumption that in general
expensive new drugs come free for such trials; otherwise this
would have significant further costs.
— Four trials per group would work
out at around £1 million per annum for each group (as described
above). Some would need more and some less but overall the ballpark
figure for 14 groups would be around £14 million per annum.
These estimates are, of course, very approximate
but at least it gives you a starting point for your recommendations.
No amount of funding is ever enough, but I believe that around
£14 million per annum, channelled through the UKCCCR, would
enable the UK to provide high quality Phase 3 cancer trials that
would lead to improved cancer treatment and more efficient use
of resources.
22 June 2000
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