Funding for treatment
Some bowel cancer treatments haven’t been approved for use in the NHS (in England, Scotland and Wales) or the Health and Social Care service (in Northern Ireland). Your cancer specialist can apply for funding for a treatment if you both agree that you would benefit from it. This page describes the application process for each nation in the UK.
Applying for treatment funding can be a difficult process and it’s not always successful. If your request is turned down, you may find the decision difficult to cope with. Macmillan Cancer Support has information on what you can do if you can’t get the treatment you need. One option may be to find out if there are any clinical trials you can join.
The National Institute for Health and Care Excellence (NICE) approves and recommends treatments and drugs for use in the NHS. If a drug is not available on the NHS, you may be able to get it through the Cancer Drugs Fund or through an individual patient funding request (IPFR). The NHS England website has a downloadable PDF factsheet on IPFRs.
The way the Cancer Drugs Fund works will change in July 2016. If NICE don’t approve a drug for use in the NHS, they may make it available through the Cancer Drugs Fund for a set amount of time. After this time, they will look at any new evidence for the benefits of the drug before deciding whether to make the drug available on the NHS.
If NICE decide there is not enough evidence to make the drug available on the NHS, you may be able to apply for it through an IPFR.
The NHS England website has a list of drugs that the fund will pay for. The list shows the criteria you must meet before you apply for a particular drug. For example, you may need to have tried all other available treatments.
Read our blog for more information on changes to the cancer drugs fund.
The Scottish Medicines Consortium (SMC) decides whether treatments should be available on the NHS. If you and your specialist think you would benefit from a treatment or drug that hasn’t been approved by the SMC, your specialist can apply to your health board. They will do this through the Peer Approved Clinical System (PACS).
NICE decides whether to recommend a treatment or drug for NHS funding. If NICE haven’t made a decision, the All Wales Medicines Strategy Group (AWMSG) will decide whether to make the drug available on the NHS. This decision could be changed if NICE produce guidance in the future.
You or your cancer specialist can apply to your Local Health Board for a drug that hasn’t been approved, if you both agree that you would benefit from it. This is called an individual patient funding request (IPFR). Your specialist will need to show that you have an exceptional need for the drug.
If they don't think they can show this need, they will tell you why not.
The Department of Health, Social Services and Public Safety looks at whether NICE has approved a drug for use in the NHS. They then decide whether to follow NICE’s guidance and whether to make the drug freely available in Northern Ireland.
If a drug isn’t funded, your specialist can apply to the Health and Social Care Board for you to have it. This is called an individual funding request.
Updated March 2016. Due for review March 2017