Access to cancer drugs in England
New cancer drugs take years of investment to develop and are, as a result, often very expensive. The Cancer Drugs Fund (CDF) was set up in England in 2010 to cover the cost of expensive new cancer drugs, including those that NICE rejected due to their high price. As a result of rising demand for drugs and prices remaining high, the CDF has become unaffordable for the NHS.
Under the current system, NICE can reject a drug for being too expensive, but the pharmaceutical companies can still charge full-price for the treatment and have it made available to men in England through the CDF - another pot of the same money. It's no secret that this system is flawed, and no wonder that it's unsustainable.
We, and other cancer charities, have long been calling for much needed change. Together with Breast Cancer Now, we co-founded the CDF Cancer Charity Coalition, and voted three representatives onto NHS England’s CDF Working Party. This group was tasked with leading the reforms to the CDF and NICE appraisal process for cancer drugs.
In November 2015, NHS England and NICE released a document outlining how they propose to reform access to cancer drugs in England, which includes major changes to the way that the CDF is used.
While we think that these proposed changes could offer a speedier and more flexible NICE appraisal process, we’re concerned that the proposed system depends entirely on the willingness of pharmaceutical companies to make many of their treatments available at a highly discounted rate - or in some cases for free - with no guarantee of full-price approval from NICE at a later date.
We’re also concerned that the new proposals will mean that drugs that do not receive a positive recommendation from NICE will never be made available to patients via the CDF. Even if a treatment does receive conditional approval, there’s potential that not all patients will get the drug they need because NICE will set out the number of patients who will receive the treatment.
Finally, with the CDF’s budget set to decrease in real terms, year on year, we’re likely to see patients get denied access to the treatments they need, as there will be less money to pay for them.
As a result, we’ve joined forces with Tackle to submit a joint response to NHS England and NICE to try and address these issues. A key part of this involved asking you for your views and we used these to inform our submission, which you can read here. Now that we have submitted our response, we will be keeping a watchful eye to see what changes – if any – are made to the proposals.