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NICE and NHS England want your views on the future of the Cancer Drugs Fund
NHS England is looking for views from both the medical profession and the general public on how the replacement for the controversial Cancer Drugs Fund (CDF) might operate.
Established in 2011, the current CDF has helped 72,000 cancer patients but has faced criticism for exceeding its budget. Spending has leapt from the original budget of £200 million when launched to an estimated spend of £340 million in 2015-16. Experts say a new system is needed, therefore the existing CDF is due to end in March 2016.
The replacement system’s outlined purpose could be described as two-fold. It is expected to exist primarily to help cancer patients access sometimes costly drugs and new treatments that – not yet approved by health watchdog the National Institute for Health and Care Excellence (NICE) - are not currently available on the NHS.
Additionally, some of these treatments may be promising new drugs which may lack evidence relating to efficacy on a wider scale. The proposed new collaborative approach could allow for valuable evidence to be collected and considered when determining whether or not a new drug will be introduced at a later date for routine use on the NHS.
Professor Peter Clark, Chair of the Cancer Drugs Fund, describes the CDF in its current form as: “no longer fit for purpose and needs to evolve – better targeting those drugs with greatest promise.”
NHS England says the proposal consultation outlines a new, fully integrated system, to work alongside the NICE appraisal process, where the CDF becomes a transitional fund – with clear criteria for entry and exit, in line with the recommendation of the recently published independent Cancer Taskforce report. However, under the proposals any final decisions would be made by NICE.
“Fast-track route to NHS funding”
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.”
Sir Bruce Keogh, National Medical Director at NHS England, says: “While it won’t avoid the ongoing need to make difficult judgements about how best to use the NHS’ funding for cancer care, the development of these proposals is a big step forward in ensuring a process which will get the most promising drugs to NHS patients at an affordable price as quickly as possible.”
“Promising medicines at a fair price”
Sir Andrew Dillon, Chief Executive of NICE, said: “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.”
Dr Matt Kaiser, Head of Research at blood cancer charity Bloodwise, says: “Thousands of patients have benefitted from the Cancer Drugs Fund since it was introduced, but the system as it stands is clearly broken. We live in an era of tailored medicine and if we are truly serious about increasing survival rates to the level of the rest of Europe, cancer patients must have access to the drugs that are likely to be most effective in treating their individual disease.
“It’s encouraging to see the Government consulting patients, charities and the pharmaceutical industry to come up with a long-term and financially viable solution.”
Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, says the announcement “signals a welcome move towards a more rational and unified system of drug evaluation”. He adds: “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.
Drug evaluation system "could speed up"
Professor Workman adds: “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.
“I welcome the fact that new patients will benefit from early access to promising treatments while further evidence is collected. It’s a good solution for the Cancer Drugs Fund to provide early access to drugs in this way.
“Drug evaluation is enormously complex, and the devil will be in the detail. The proof of success will be in more, and particularly more innovative, drugs actually reaching patients on the NHS.”
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