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The National Institute for Health and Care Excellence (NICE) is responsible for appraising new drugs and deciding whether they are clinically and cost-effective enough to be approved for NHS funding. The Cancer Drugs Fund (CDF) was created in April 2011 as an alternative funding avenue to aid patient access to drugs that were not routinely available on the NHS, either because NICE had not recommended it or it had not yet been appraised. The CDF is only available to patients living in England (as the Scottish, Welsh and Northern Irish governments individually determine what drugs are available to their NHS patients) and the budget is now £340 million a year.
Since its beginning, the CDF has enabled thousands of cancer patients to access innovative and effective treatments which do not fit the criteria for mainstream NHS funding. The fund, however, was originally intended to be an interim measure only whilst drugs were being appraised by NICE or to allow treatments for rarer diseases (that would not be recommended) through the system. It was created to ensure that more patients had access to the treatment that they needed. As more treatments were determined as clinically effective but not cost effective, the CDF became strained and the budget had to be increased twice from £200m to £340m. This increase in budget inevitably had a financial impact on other cancer services and it has been widely acknowledged that this model of the fund is no longer financially sustainable. As such, the government is reviewing the operating model of the fund and in its current form the CDF is due to end in March 2016.
The purpose of the review is to determine the future of the Cancer Drugs Fund with an aim to ensure patient access to new life-saving drugs. Under the proposed model, NICE will award all new cancer drugs with either a “yes” (in which they are commissioned by NICE), a “maybe” (where they will be CDF funded for a time limited period) or a definite “no” (where they will not be funded) decision within 90 days of market authorisation.
Under the proposals put forward by NICE the CDF will provide interim funding for new treatments that demonstrate “genuine promise” (but where the data is uncertain) whilst evidence is collected on how well the drug works in real world situations. Each treatment will be funded for no more than two years whilst the “real world evidence” is being collated and it will then be determined whether the treatment should be accepted for routine use in the NHS in the future. If NICE decide it should be commissioned, it will be funded. If they decide not to recommend the drug then it is proposed that the pharmaceutical company will continue to fund the drug for patients who have already been receiving it via the CDF. It is hoped that this method of ensuring patient access to treatments will be more financially sustainable than the previous one.
Simon Stevens, Chief Executive of NHS England, said: “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.”[Source: https://www.england.nhs.uk/2015/11/19/cdf-consultations/]
The public, as well as organisations like Leukaemia CARE, are being given the opportunity to comment on the proposals for the new model of the Cancer Drugs Fund until the 11th February 2016. NICE have stated that they would like the involvement of patients and potential patients in the planning and sustainability of the CDF so that informed decisions can be made regarding the future of the governments methods of funding life-saving cancer treatments.
Monica Izmajlowicz, Leukaemia CARE Chief Executive, has commented:
“The Cancer Drugs Fund was intended to be a temporary funding measure to provide access to treatments whilst a solution to the problems with the NICE process was found. Whilst the CDF has enabled thousands of patients to access innovative treatments, in its current form the CDF has become financially unsustainable, leading to these proposals for its reform.
As a patient organisation we work to increase patient access to innovative, effective treatments and welcome any reform that will ensure access to drugs for patients that truly need them. We would encourage anybody with an interest in blood cancers to respond to the consultation and share their views as to whether the proposed new system will improve access to drugs for these patients.”
If you feel that you would like to contribute a response to the consultation then you can:
Alternatively, if you have any questions regarding the consultation or feel that you would like us to put your questions and comments forward to the National Institute for Health and Care Excellence (NICE) on your behalf then you can email email@example.com or telephone the Campaigns and Advocacy team on 01905 755 977