Care Pathways

Financial boost for Cancer Drugs Fund, but cut in treatments

The NHS has announced plans to stop funding 25 treatments for cancer, including some used for breast, prostate and bowel cancer, causing outrage among many charities. 

Following a review of the Cancer Drugs Fund (CDF), it was announced that funding would be boosted to £340m from April, but 16 drugs that it pays for have been ‘delisted’. 

Cancer charities have warned that the decision will potentially ‘harm’ some patients, as they cannot access life-saving or lengthening treatments. 

NHS England said, however, that while the number of drug treatments for next year, funded through CDF, had been reduced from 84 to 59, it created “headroom for new indications that will be funded for the first time”. 

The Coalition introduced the CDF in 2011, following a Conservative election manifesto pledge that treatments should no longer be denied on grounds of cost. 

Although its budget was increased from £200m to £280m, demand has increased so much that it was forecasting to have spent £380m by the end of the financial year. 

The restrictions, which commence from March 2015, are expected to create projected savings of £80m through a combination of negotiated price reductions and improved clinical effectiveness. 

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 offer the best clinical benefit, getting the most for patients from every pound. 

“There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those. These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.” 

Most cancer drugs are routinely funded outside of the CDF, but the fund, which is currently due to run until March 2016, provides a supplementary funding route for some other cancer drugs. 

But Stephen Whitehead, chief executive of the Association of the British Pharmaceutical Industry, said that NHS England’s decision to delist 16 cancer medicines with 25 separate clinical uses is “extremely disappointing” and a significant blow to the health and wellbeing of future NHS patients. 

“Whilst we are pleased that treatment for existing patients will be protected as a result of this decision and that some new medicines will be included in the CDF it does not detract from our longstanding belief that the CDF and this re-evaluation process was fundamentally flawed. The CDF remains a sticking plaster,” he said. 

“The solution to this issue remains the urgent reform of NICE which will ensure that the right patients get the right medicines at the right time whatever their condition.” 

Mark Flannagan, chief executive of the charity Beating Bowel Cancer, added that the delisting of treatments including Afilbercept (Zaltrap), Bevacizumab (Avastin), Cetuximab (Erbitux) and Pantiumumab (Vectibix), is bad news for patients. 

“It’s likely that 65% of patients with advanced bowel cancer face the probability of an earlier death by being refused innovative treatments that were available before,” he said, adding that the changes are “a backward step in treatment for advanced bowel cancer”. 

Patients already receiving drugs through the CDF, however, will continue to do so, and any drug that is the only therapy available for a particular form of cancer will remain on the list, NHS England said. 

Samia al Qadhi, chief executive at Breast Cancer Care, stated that the CDF is “falling apart” when there is still no long-term solution in place. 

“While it is good that another three breast cancer drugs remain on the list and budget for the Cancer Drugs Fund will grow, the priority now must be to urgently find a sustainable system that works,” she said. 

A Department of Health spokesman added that the government wants people to have access to the very latest drugs. “That is why experts have made decisions to stop routinely funding drugs with limited clinical benefit”. 

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