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NHS England has published an updated Cancer Drugs Fund (CDF) list following decisions, made by cancer doctors and patient representatives at the last national CDF panel meeting, that aim to deliver the maximum clinical benefit for patients.
The updated CDF list reflects the outcomes of the appeals from pharmaceutical companies following the removal of drugs after the panel meeting in December 2014. Decisions on seven new applications to the Fund have also been published.
NHS England has also made some factual changes and clarifications to the Standard Operating Procedures for the Cancer Drugs Fund – the formal process the CDF panel follows when making decisions. It plans to make some further changes and today launched a four-week consultation on these.
Professor Peter Clark, Chair of the CDF and a practising oncologist, said: “We have been through a robust, evidence-based process to ensure the drugs available through the CDF continue to offer the best clinical benefit, getting the most for patients from every pound that we have.
“These are difficult decisions, but if we don’t continue to prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”
In December, the national CDF Panel took a careful look at how we ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound. Following this prioritisation process, drug manufacturers had the opportunity to request that the Cancer Programme of Care Board review their case. The review looked at whether the Standard Operating Procedures, on which we publicly consulted, were fully followed. It did not look at the medical decisions made by doctors on the national CDF Panel.
The Board referred five of these back to the CDF panel to review at the last panel meeting, which were also considered alongside new applications for inclusion in the CDF in the normal way.
After careful consideration, one of the five drug indications that were looked at again will remain on the CDF (Regorafenib). Four will no longer be available, as previously announced in January.
Any patient already being treated with any of the drugs that have been subject to appeal will continue to receive their drug. 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 a clinically exceptional basis.
The CDF is due to run until 1 April 2016. NHS England is working with charities, NICE, and the pharmaceutical industry, to develop a longer-term sustainable approach to the evaluation and commissioning of cancer drugs.
Until a new system is in place, the process of reviewing and prioritising drugs on the CDF list will take place regularly in order to maintain a sustainable fund and make headway for more effective drugs on the horizon.
- In December a national panel – comprising oncologists, haematologists, pharmacists and patient representatives -independently reviewed the drug indications 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.
- In January 59 of the 84 most effective approved indications (clinical ‘uses’) of drugs remained in the CDF for the forthcoming year, creating headroom for three new drug indications.