The new Cancer Drugs Fund. It may be new but has it improved?
Recently a new Cancer Drugs Fund (CDF) came into effect, which changes the way cancer drugs are assessed and funded in England. Previously, the CDF funded all cancer drugs that were not approved by the National Institute for Health and Care Excellence (NICE ) for use on the NHS. However this was deemed to be financially unsustainable and so NHS England and NICE set about looking at how the way cancer drugs are funded could be changed to ensure patients get faster access to the most effective drugs but still be cost-effective for the NHS.
Now the changes have been finalised and have come into effect we explain how the new CDF will work and what it means for access to bowel cancer drugs.
How will it work?
Under the new system, all cancer drugs will be assessed by NICE. Cancer drugs will be given one of three recommendations:
- Yes – Recommended for use on the NHS
- No – Not recommended for use on the NHS
- Conditional approval – the drug has the potential to meet NICE cost-effectiveness criteria but more evidence is needed to recommend for use on the NHS
If a drug is given conditional approval, it will move into the CDF for a period of up to two years while real world evidence is gathered but only if the pharmaceutical company agrees. During this time all eligible patients will be able to access the drug.
What happens after the two years?
After the two years, the drug will go through an accelerated NICE reappraisal process. Based on the additional evidence collected during the time the drug is available on the CDF, NICE will either recommend the drug for use on the NHS or it will not recommend it. A negative NICE decision, at this point, will mean that patients will only be able to access the drug through an individual funding request.
What about the bowel cancer drugs that were on the previous CDF?
Over the next 12 months, NICE will be reappraising all the drugs that were on the previous CDF as of 31 March 2016.
The following bowel cancer drugs were on the CDF and are still available to people who meet the criteria:
- Erbitux (cetuximab)
- Vecitibix (panitumumab)
Until both these drugs are reappraised, patients can still access them if they meet the criteria.
If after this process they are not recommended for use on the NHS, a notice period of two months will be given. Patients already receiving the drug will continue to have access to it but it will be no longer be available to new patients after this two-month window.
Our Concerns
While the proposals seem like a positive step forward, there is still a lot of uncertainty around how they will work in practice. For example, we are unclear on what type of data is needed for a drug to go from conditional approval to receive a positive recommendation and how this data should be collected. Furthermore the CDF was, in part, created in recognition that assessment of cancer drugs by NICE was failing patients. With no significant changes to the criteria used by NICE, we are concerned about the possibility that patients may have access to fewer drugs.
Some Good News
NICE has recently published final draft guidance approving Lonsurf (a drug combining trifluridine and tipiracil) for patients with advanced bowel cancer who have previously had treatment.
What’s next?
We’re closely following the progress of the new CDF and keeping an eye on whether it will actually increase access to bowel cancer drugs. We’ll also be working in coalition with our charity partners to raise our concerns and campaign to improve access to the most effective treatments.
What can you do?
If you’ve had positive or negative experience accessing bowel cancer drugs in the UK please share your story with us. You can also join our Campaign Supporters Network to receive updates about our campaigning work and how you can take action.
By Asha Kaur, Policy Manager, Bowel Cancer UK