OBJECTIVES: The COVID-19 pandemic has placed an unprecedented demand on healthcare systems. Cancer therapy provision has been particularly impacted due to many therapies having immunosuppressive side effects and/or their need for hospital administration. NHS England (NHSE) and the Scottish National Cancer Advisory Medicines Group (NCMAG) have both provided interim treatment recommendations to provide direction for oncologists during this pandemic. This research evaluates these NHSE and NCMAG treatment proposals.

METHODS: All interim cancer treatment proposals made under NHSE and NCMAG were extracted and compared with the corresponding product label and any NICE/SMC HTA guidance (on 30-Dec-2020).

RESULTS: NCMAG made 18 interim cancer treatment proposals (last updated 10-NOV-2020). 33% were for off-label use, 17% were on-label therapies without SMC-recommendations (all manufacturer non-submissions), 11% were for use outside of SMC reimbursement restrictions, 11% related to supportive care, 11% restricted dosing, and 6% stopped use of one drug in favor of another. NHSE have endorsed 48 interim treatment options (last updated 20-NOV-2020). 40% were for off-label use, 19% stopped use of one drug in favor of another, 9% simply stopped use of a drug, 9% were for therapies that were ongoing NICE assessment (half of which were subsequently NICE-recommended), 9% were for on-label therapies that were not NICE-recommended nor undergoing assessment, 9% were treatment dosing modifications (i.e. duration/frequency/combination), and 5% related to supportive care. 33% of proposals by NCMAG had corresponding recommendations by NHSE.

CONCLUSIONS: In England and Scotland, rapid interim treatment guidance has provided physicians with a greater flexibility in treating patients with cancer with the guidance most commonly focusing on allowing use of certain therapies outside their labels or their SMC/NICE reimbursement restrictions. There is a lack of alignment between England and Scotland, which can only likely be partially explained by differences in drugs recommended by NICE and SMC