Cancer Drugs Fund to run until 2016
pharmafile | September 30, 2013 | News story | Research and Development, Sales and Marketing | CDF, Cameron, NHS, NICE, VBP
England’s Cancer Drugs Fund will run until 2016 and be given a £400 million boost under plans announced by the government this weekend.
As reported by Pharmafile on Friday, the Fund was meant to be axed in March next year but the prime minister David Cameron has opted to extend its use until the next election.
The Cancer Drugs Fund (CDF) was set up in October 2010 and was designed to inject £650 million into the NHS until 2014 for new cancer drugs that were rejected by NICE, or under appraisal by the watchdog.
The new funding stream will see an extra £200 million given to the NHS each year until the next election, bringing the total spent on these medicines to over £1 billion.
The Fund was meant to be just a stop-gap before the government’s new value-based pricing (VBP) scheme which comes into effect from January, that is designed to stop the need for any specialist funding for new cancer medicines.
But prime minister David Cameron’s announcement at his Conservative Party’s conference this weekend is a tacit recognition that the VBP plans cannot deliver on its promise of better access.
The government has not spoken directly about the impact this will have on VBP. Cameron said on Saturday: “When I became prime minister three years ago, many patients with rare cancers were being denied lifesaving treatments.
“That is why we created the Cancer Drugs Fund, it is why we are extending it, and it is why we are partnering with Cancer Research UK to conduct new research into the effectiveness of cancer drugs. It is only because we have protected health spending that we can afford these lifesaving treatments.”
The health secretary Jeremy Hunt said the government had made an exception for cancer because they considered it ‘the number one killer’, adding: “we do think that we had a particular problem with a lack of access to these drugs.”
A number of cancer charities, including the Rarer Cancers Foundation which lobbied for the Fund, have welcomed the move, but the Opposition Party Labour accused the prime minister of ‘letting down’ patients.
Shadow health minister Liz Kendall highlighted the fact that expert cancer networks – set up to improve access to high quality services – were scrapped during the reorganisation of the NHS earlier this year.
She added: “David Cameron should also stand up to the tobacco lobby rather than caving in to them over standardised cigarette packaging, which experts say would be a powerful weapon in the long-term fight against cancer.”
The two most commonly prescribed drugs via the Fund have consistently been Roche’s Avastin and Merck Serono’s Erbitux, which both have licenses for colorectal cancer.
Roche’s Avastin also has licenses for ovarian, lung, breast and kidney cancers, but has been rejected for all of them by NICE, despite being the biggest selling cancer treatment in the world.
There was talk that these and other popular medicines would be assessed under VBP plans in order to increase their uptake, but this would have been more complicated than simply extending the Fund.
Editor’s comment
The government tried, unsuccessfully as it turned out, to curb NICE’s ability to recommend or reject drugs, meaning it will still be holding all the cards when VBP comes into place. This is most likely the reason why the CDF needed to remain, lest the government wanted politically sensitive rejections to once again be splashed over tabloid front pages, notably the Daily Mail.
But the problems of access will not be solved by merely throwing more money at it, and some pharma firms have said to Pharmafile that they would rather see a systemic change on the drug pricing system to ensure better uptake, rather than a political fund which can be rescinded at any time.
There is also the question about whether these medicines are simply too expensive in the context of their efficacy. If NICE rejects a medicine then it simply is not cost effective – but the existence of the Fund detracts from this, and focusses on the rejection itself, rather than the reason for NICE’s ‘no’ decision.
But by far the biggest concern should be the way emotions and the politics around the disease have been played on in order to have the Fund stay. By 2016 the government will have handed over around £1 billon extra to the pharma industry for many drugs NICE have deemed not cost effective.
The issue at hand is whether the medicines rejected by NICE and paid for by the CDF have improved outcomes, as well as access. There seems to be no central data on whether patients taking these NICE-rejected medicines have seen increased overall survival, progression-free survival, or better outcomes in other measurable ways.
Until these data are collated and examined – in line with the cost of the medicines they have taken – then the Fund cannot be deemed a success.
Ben Adams
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