On 1 April 2013, NHS England took on responsibility for the operational management of the Cancer Drugs Fund (CDF). The NHS spends approximately £1.3 billion annually on the provision of cancer drugs within routine commissioning. The CDF was established as an additional funding source to this.
The CDF has provided an additional £200m each year since then to enable patients to access drugs that would not otherwise have been routinely available from the NHS. NHS England recently pledged an additional £160m over the next two years to strengthen the fund. It was established in 2010 and will run until the end of March 2016.
There is a single, national list of drugs and indications that the CDF will routinely fund and standard operating procedures for administration of the fund.
The list of drugs and indications has been originally compiled by NHS England Clinical Reference Group (CRG) for Chemotherapy working with the local clinician leads who oversaw the administration of the ten regional CDFs.
The Chemotherapy CRG continues to play a key role in the management of the CDF through the national CDF panel, a sub-group of the CRG. The chair makes recommendations to NHS England as to how the list should be developed and the group has adopted a formal process of horizon-scanning for new treatments which could have potential benefits for specific groups (cohorts) of patients.
NHS England oversees the fund, with day to day administration carried out by the four regional teams based in the following areas:
The list includes drugs and associated indications that will be routinely funded by the CDF. Additionally, NHS England will consider Individual CDF Requests (ICDFRs) for cancer medicines to treat individuals with rarer types of cancers including those affecting children.
The Standard Operating Procedures for the CDF 2015/16 set out how the fund will be managed, as well as the process for applications – both for drugs with an identified cohort of patients and for individual CDF requests. The SOP was last revised in November 2014, following a period of public consultation. The changes made to the document at that time enabled the fund to achieve the best overall clinical benefit for patients, within the fund’s annual budget.
Experience of using the document highlighted a number of areas which require clarification and/or correction in order that the Cancer Drugs Fund can operate effectively. Amendments such as these do not require consultation, and the document has now been amended for use during 2015/16. All of the adopted amendments fall into two categories, which are clearly marked in the document. They are:
There are a number of additional, proposed changes to the SOP, which are the subject of public consultation.
Applications to the fund must be made on behalf of patients by a recognised and accredited cancer specialist and must be supported by the NHS trust/foundation trust’s clinical cancer lead. Each drug and indication has its own application form and all relevant clinical criteria for use have to be satisfied.
Detailed information on eligibility, the evidence required and the procedure for applications can be found in the CDF Standard Operating Procedures. In summary, the process will follow the steps below.
The Individual Cancer Drug Fund Request form can be found here. Application forms and details of how to submit requests to the CDF are also available: