The budget for the CDF will grow from £200 million in 2013/14, to £280 million in 2014/15, and an estimated £340 million from April 2015. This represents a total increase of 70 per cent since August 2014.
The CDF review announced yesterday also will create projected savings of approximately £80 million through a combination of negotiated price reductions and improved clinical effectiveness. If action had not been taken to review the CDF drugs list, the Fund is projected to have grown to around £420 million next year, necessitating offsetting cuts in other aspects of cancer treatment such as radiotherapy, cancer diagnoses, cancer surgery, and other important NHS services for other patient groups.
A national panel – comprising oncologists, pharmacists and patient representatives – independently reviewed the drug indications* currently available through the CDF, plus new applications. They carried out a detailed assessment of the evidence, looking at clinical benefit, survival and quality of life, the toxicity and safety of the treatment, the level of unmet need and the median cost per patient. In cases where the high cost of a drug would lead to its exclusion from CDF, manufacturers were given an opportunity to reduce prices.
The result of the review is that 59 of the 84 most effective currently approved indications (clinical ‘uses’) of drugs will rollover into the CDF next year, creating headroom for new drug indications that will be funded for the first time. These are Panitumumab, a treatment for bowel cancer; Ibrutinib, a treatment for Mantle cell lymphoma, a type of non-Hodgkin lymphoma; and Ibrutinib for use in chronic lymphocytic leukaemia (CLL).
Following these changes, four important patient protections are in place:
- Any patient currently receiving a drug through the CDF will continue to receive it, regardless of whether it remains in the CDF.
- Drugs which are the only therapy for the cancer in question will remain available through the CDF.
- If the CDF panel removes a drug for a particular indication, some patients may instead be able to receive it in another line of therapy or receive an alternative CDF approved drug.
- Clinicians can apply for their patient to receive a drug not available through the CDF on an exceptional basis.
Professor Peter Clark, Chair of the Cancer Drugs Fund (CDF) and a practising oncologist, said:
“We have been through a robust, evidence-based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound.
“There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those. There were others that offered some benefit but were costly and I am pleased that a number of pharmaceutical firms worked with us to make prices more affordable, saving millions of pounds that can now be reinvested in other treatments.
“These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”
- * An ‘indication’ is a medical term for a condition or set of symptoms for which a drug is provided – a drug may be used for several indications.
- Most cancer drugs are routinely funded outside of the CDF. The CDF – set up in 2010 and currently due to run until March 2016 – provides a supplementary funding route for some other cancer drugs. NHS England is working with cancer charities, the pharmaceutical industry and NICE to create a sustainable model for the commissioning of chemotherapy.
- Following public consultation, action is being taken to ensure a sustainable future for the CDF and to get maximum value for patients by ensuring every pound is spent on the most effective drugs available.
- NHS England has set up an appeals process by which pharmaceutical companies can challenge the process of decision making.
- A national taskforce will produce a refreshed five year cancer plan for the NHS, headed by Harpal Kumar, chief executive of Cancer Research UK.
Sources and more information
- NHS increases budget for cancer drugs fund from £280 million in 2014/15 to an expected £340 million in 2015/16, NHS News, 12 January 2015.
Outcome of consultation on proposed changes to Cancer Drug Fund Standard Operating Procedures, NHS News, 12 January 2015.
- Cancer Drug Fund decision summaries, NHS News, 12 January 2015.
- Cuts to cancer treatments announced, BBC News Healtn, 12 January 2015.
- Cancer Drugs Fund: Life-extending drugs to be denied to NHS patients in England as fund overspends, The Independent, 12 January 2015.
- 25 cancer drugs to be denied on NHS, The Telegraph, 12 January 2015.