A 12-week consultation on draft proposals for a revamped Cancer Drugs Fund (CDF) has been launched by NHS England and NICE, recommending that the Fund operates within the two organisations.
The original CDF, established in 2011 to fund cancer drugs in England that are not currently approved by NICE, will expire in April 2016. The Fund has helped more than 72,000 cancer patients in England access drugs not routinely funded, but with budgets under strain, and increasing numbers of therapies being pulled from the scheme, it is now widely acknowledged that a new system is needed.
The proposal issued today for public consultation outlines a new system, fully integrated into the NICE appraisal process, where the CDF becomes a ‘managed access’ fund for new cancer drugs to give early access to those drugs which appear promising but which currently lack robust evidence bases to support a recommendation for routine commissioning.
This approach is in line with the recommendation of the recently-published independent Cancer Taskforce report, which also proposed that the new CDF should operate with NHS England and NICE.
NHS England says the new CDF will aim to help patients receive new treatments with genuine promise, while real world evidence is collected for up to two years on how well they work in practice. This will then help determine whether the treatment should be accepted for routine use in the NHS in the future.
NICE added that the proposals intend to provide patients with access to promising new medicines while the evidence is still emerging, in a financially sustainable way.
Simon Stevens, chief executive of NHS England, says: “Over the next five years, we’re likely to see many new cancer drugs coming on to the worldwide market – some of which will be major therapeutic breakthroughs, and some of which will turn out to offer little extra patient benefit but at enormous cost.
“The new Cancer Drugs Fund offers a route for sorting out the wheat from the chaff, so that patients in England get faster access to the genuinely most promising new treatments. For those drug companies willing to price their products affordably while sharing transparent information about ‘real world’ patient benefit, the new CDF will offer a new fast-track route to NHS funding.”
Professor Peter Clark, chair of the Cancer Drugs Fund, said: “The CDF has enabled thousands of cancer patients to access treatments that were not routinely available on the NHS. However, there is now a consensus that in its current form it is no longer fit for purpose and needs to evolve – better targeting those drugs with greatest promise.”
Sir Andrew Dillon, chief executive of NICE, adds: “The joint NHS England and NICE proposals will ensure that the Cancer Drugs Fund is used to provide patients with promising medicines at a fair price, and at the same time, generate additional data to help the NHS make a longer term decision on whether and how to use them.”
Professor Paul Workman, chief executive of The Institute of Cancer Research, London, welcomed the move towards a “more rational and unified system of drug evaluation,” adding: “It does make sense for the Cancer Drugs Fund to pay for new drugs only after a provisional green light from NICE, to avoid duplicating the processes for deciding whether drugs should be made available on the NHS.
“There are also promising signs of a desire to address the bottleneck we have in cancer drugs being approved for use on the NHS. The proposals could speed up the drug evaluation system – which is good news for everyone – and would increase the number of drugs which would be available for consideration under end-of-life criteria.”