Approved Minutes of the 8th NICaN Regional Oncology / Haematology D&T Committee NICaN

Wednesday 24th October 2007

8th NICaN Regional Oncology / Haematology D&T Committee

Wednesday 24th October 2007

Plum Room, Holywell Hospital, Antrim

2.00pm – 5.00pm

Record of attendees:

Mr Brian Baker RMSC

Ms Sally Campalini Cancer Centre, Belfast Trust

Dr Alison Clayton Medical Oncology, Belfast Trust

Dr Gerard Daly NICaN Team

Dr Martin Eatock Chair

Mr David Galloway DHSSPS

Ms Fionnuala Green Regional co-ordinator Cancer Services Pharmacist

Dr Adrian Mairs RMSC

Professor Curly Morris Haematology, Belfast Trust

Ms Jill MacIntyre NICaN Pharmacy Group

Janis McCulla NICaN Team (Patient and Public Involvement)

Ms Maire McGrady Regional co-ordinator Cancer Services Pharmacist

Ms Sandra McKillop NICaN Team

Professor Ciaran O’Neill QUB

Ms Cora Sonner Representative of NICaN Pharmacy G6

Ms Bridget Tourish NICaN Team

Apologies: Mr Mark Timoney, Dr Seamus McAleer, Dr Robert Harte and Ms Elizabeth England.

Welcome and Introductions

Dr Eatock welcomed members to the 8th meeting of the Committee, introductions were made and apologies noted as recorded above.

DT_0710_41 Sign off and Matters arising from Minutes of 7th Meeting – 12/09/07

The minutes of the meeting held on 12th September were agreed as accurate without amendment.

Sunitinib Update

Dr Eatock advised the group that the ‘Status Quo’ applies in relation to Sunitinib, being the ongoing process of cost per case requests for this drug.

Action: It was agreed that a generic policy relating to ‘cost per case’ applications would be uploaded onto the website with the addition of a paragraph detailing that once a decision is made, it should be communicated to Clinicians and copied to finance and pharmacy. It was proposed that Dr Adrian Mairs produce a generic policy based on Dr Harpur’s policy for sunitinib.

Business Case Template

It was noted that minor amendments have been made to the business case template.

Action: Updated template to be uploaded onto NICaN website.

Dasatinib Business Case Update

Dr Eatock advised the group that Dr Cuthbert has provided feedback in relation to the queries raised in the consideration of the business case.

Ms Sonner raised the question as to whether Dasatinib be reconsidered, Dr Eatock advised that the business case will be reconsidered and that the letter from Dr Cuthbert should be appended to the business case.

Patient and Public Involvement

Dr Eatock advised the group that Ms Nicola Porter will be in attendance at the next meeting of the Committee and it was noted that Dr Eatock has met with Ms Porter. Ms McCulla (Regional Coordinator, Patient and Public Involvement) advised that there may also be a Pharmacist interested in representing the Patient perspective on the group.

Process for Business Cases

Ms Sonner queried the communication of outcomes of business cases and what information can be disclosed to the service and at what stage. Dr Eatock advised that the documented discussion in relation to the business cases can be shared and will be available from the NICaN office for information; however the actual business case documents are confidential

Discussion then arose in relation to the communication regarding the status of business cases to the service and it was agreed that there should be a status table available on the NICaN website which details stages of business cases submitted to the Committee for consideration.

Action: Ms Green to develop status table for uploading on the website and this table should be maintained with regular updates.

Ms Tourish to ensure that business case discussion/scoring sheets be regularly uploaded to the website.

DT_0710_42 Horizon Scanning Document – Restricted Circulation

Ms McGrady provided update and noted that the tables within the document are not static and thus sought feedback from the group in relation the content of the tables. It was noted that although this is confidential information, it would be useful to circulate to Oncology and Haematology teams to gain comments.

Action: Document to be shared with Chairs and Clinical leads of Tumour networks for information purposes.

It was agreed that the Horizon scanning document be completed twice yearly in line with the drug prioritisation list once a year.

Consideration to be given to the coordination of information between DHSSPS, RMSC and the Regional Co-ordinator for Cancer Services Pharmacist.

DT_0710_43 Validation of Prioritisation Template

It was agreed that the Drug Prioritisation Template should be changed to reflect amendment to score available for evidence.

Action: Score for quality of evidence to be increased to a maximum of 20 and original sub-group to be reconvened to consider template again.

DT_0710_44 RMSC Update

No further update available

DT_0710_45 Business Cases

Ms Sonner queried whether the presented business cases could be discussed as some did not include Service Impact Assessments which would be essential for approval.

Action: Dr Eatock to contact authors of business cases to ensure service impact assessment is completed and submitted with business cases to RMSC.

The following business cases were discussed, scoring sheets detailing summary of discussions are attached and these will also be available via the NICaN website.

·  Docetaxal in locally advanced Head and Neck Cancer

·  Erlotinib in advanced non small cell lung cancer (NSCLC)

·  Pemetrexed Mesothelioma

·  Rituximab Maintenance in relapsed/refractory follicular lymphoma

·  Lenalidomide for use in Multiple Myeloma

·  Sunitinib Malate for 1st line treatment in Metastatic Renal cell Carcinoma

DT_0710_52 Finalisation of Prioritised list to include in New Drug Paper for RMSC

The prioritised list was agreed as follows:

·  Rituximab Maintenance in relapsed/refractory follicular lymphoma

·  Docetaxal in locally advanced Head and Neck Cancer

·  Pemetrexed Mesothelioma

·  Erlotinib in advanced non small cell lung cancer (NSCLC)

Any other business

Professor Morris questioned the position in relation to orphan drugs that will not reach RMSC or NICE. It was noted that that such drugs have low usage, however may have an improved impact on the quality of life for patients.

Discussion arose as to whether there is a need for a process for exceptional cases such as ‘in house’ peer review?

Action: Proposed process to be if agreed ‘in-house’, contact to be made with Director of Public Health for relevant Board area. It was agreed that this process should be confirmed with Mr Baker and Dr Mairs.

Date of next meeting

The next meeting of the Drugs and Therapeutics Committee will be held on Wednesday 16th January, 2008, 2.00pm – 5.00pm, Venue TBC.

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