11.03.15
CDF cuts will compromise best treatment choices, say oncologists
More than three-quarters of oncologists believe that NHS England’s plans to remove medicines from the Cancer Drugs Fund (CDF) will harm their ability to make the best treatment choices for their patients.
An online survey of 115 oncologists, sampled from the doctors.net.uk community, revealed that 74% believe the CDF panel placed budgetary considerations ahead of what’s best for cancer patients when they made their decisions about cuts to the CDF.
The report, commissioned by Sanofi UK, highlighted that two-thirds of prostate cancer clinicians said that following the removal of cabazitaxel (Jevtana) from the CDF, they expect to manage prostate cancer with less effective treatment for longer.
Professor Amit Bahl, consultant clinical oncologist and clinical director at Bristol Haematology and Oncology Centre, said: “It will be highly detrimental if NHS England goes ahead and de-lists cabazitaxel. It is an important treatment for some men with prostate cancer who may have no other treatment options available to them.”
NHS England has reiterated that any patient already receiving a drug through the CDF will continue to receive it, regardless of whether it remains in the CDF. Also, drugs that are the only therapy for a particular cancer will remain available via the CDF.
It also said that 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, and that clinicians can apply for their patient to receive a drug not available through the CDF on an exceptional basis.
The CDF was set up as an interim measure by the coalition government in 2010 to facilitate better access to cancer drugs. Drugs on the CDF list are those that either haven’t yet been approved by the National Institute for Health and Care Excellence (NICE) and aren’t available within the NHS in England, or following appraisal haven’t been deemed cost effective.
Sanofi argues that the CDF, which will run until the end of march 2016 when a new way of setting prices for cancer drugs is introduced, only accounts for 0.3% of the total NHS spend and only 2.5% of the NHS drugs bill. So plans to cut drugs from the CDF are surprising, it added.
The company has asked the prime minister to intervene on this matter, and allow the company and clinicians to discuss with the CDF Panel the decision to cut cabazitaxel, and develop a solution that meets “patient need”.
Professor Peter Clark, Chair of the Cancer Drugs Fund (CDF) and a practising oncologist, said: “NHS cancer doctors have taken a careful independent look at how we ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound. 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. No patient currently getting CDF drugs will miss out, and even for drugs not in the Cancer Drugs Fund, oncologists can apply for individual patient funding.”
Lord Darzi, one of the UK’s leading surgeons and cancer experts, as well as a noted leader in health policy and innovation, recently wrote for NHE arguing that the Cancer Drugs Fund has bypassed the principles of fairness and value for money on which NICE was founded.
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