In England, the National Institute for Health and Care Excellence (NICE) decides whether a new treatment should be made available on the NHS.
NICE weighs up the evidence on how well a treatment works and how much it costs. It then recommends whether or not the treatment should be available on the NHS in England. It takes several months for NICE to reach a decision.
If a treatment is recommended by NICE and it’s suitable for you, your hospital legally has to provide it for you.
Can I get a medicine on the NHS before NICE has recommended it?
Usually, hospitals won’t make a licensed medicine available on the NHS before it is recommended by NICE. But your doctor may still be able to get it for you by applying to the Cancer Drugs Fund (CDF).
What is the Cancer Drugs Fund?
The Cancer Drugs Fund is money the English government has put aside to pay for some cancer drugs in England. These are drugs that have not been approved by NICE and are not available on the NHS. The fund covers:
- medicines that NICE has not yet looked at
- medicines that NICE is currently looking at
- medicines that NICE has looked at and said do not work well enough, or are very expensive when compared to the amount of benefit they might give men
- medicines that NICE has looked at, but has only recommended for a very specific group of patients.
The aim of the fund is to allow people with cancer to get the medicines that doctors think will help them. It’s only available in England.
How does the Cancer Drugs Fund work?
There’s a list of medicines, called a priority list, that are available through the Cancer Drugs Fund. There are usually guidelines about who each medicine is suitable for. For example, the guidelines might say which treatments you need to have already had before getting a drug on the list.
If your doctor thinks a medicine on the priority list is suitable for you and you want to have it, they need to apply for it for you. You cannot apply directly yourself.
Abiraterone and enzalutamide before chemotherapy, cabazitaxel and radium-223 are all on the priority list. This means that if one of these is suitable for you, it is likely that you will be able to have it.
You should get a decision about whether you can have the drug within 31 days. But it’s often sooner than this. If the decision is no, you will be given clear reasons why. Your doctor can appeal against the decision if they believe important information has been overlooked, or if your condition changes.
Ask your doctor for more information about the Cancer Drugs Fund. You can also get more detailed information from Cancer Research UK.