Cancer Drug Fund News
28 Aug. 2014
28/08/14 – NHS England have announced the allocation of further funds for the Cancer Drug Fund (CDF)
This is good news for cancer patients, whilst we are waiting to see how NICE will finally alter their appraisal system, following the recent consultation on Value Based Assessments (VBA).
However – the CDF is only a temporary solution to a long-term problem.
Until NICE resolves the issues it has with appraising drugs for rare diseases, and working with scarce data, we will continue to need a CDF to temporarily plug the gaps.
HTA stakeholders do assist NICE in every way they can – in their search for a better understanding or more precise data, or to correct misunderstandings – but this takes time, efforts and money. And in rare or life-threatening diseases – time is something most patients don’t have much of.
Here is the full article, from the CDF webpage:
“NHS England sets out plan for a sustainable Cancer Drugs Fund – 28 August 2014 – 00:01
NHS England has today pledged a £160m boost over two years for the Cancer Drugs Fund, giving more patients access to innovative drugs not routinely available on the NHS.
Two new drugs will now also be added to the Fund; enzalutamide for prostate cancer and lenalidomide for a group of patients with myelodysplastic syndrome, a rare blood condition. (* see note below for lenalidomide clarification)
With an annual budget of £200m, now rising by 40 per cent to £280m, the Fund has delivered important benefits for more than 55,000 patients since it began in 2010.
Professor Peter Clark, Chair of the Cancer Drugs Fund (CDF), has written to NHS England Chief Executive Simon Stevens recommending CDF’s panel of experts re-evaluate a number of drugs currently on the list, making evidence-based decisions about what will deliver greatest benefit to patients. NHS England has accepted and agreed these proposals. Copies of the letters are on the NHS England website.
Professor Clark, who is an oncologist, said: “The Cancer Drugs Fund has had a positive impact on cancer treatment for patients, with 2,000 people gaining access to the Fund every month. To ensure patients continue to have access to the best innovative treatments now and in the future, we must re-evaluate some of the drugs on the list. This is absolutely the right thing to do for patients, and I am pleased Simon Stevens has accepted my recommendations.”
Responding to Professor Clark’s proposal, Simon Stevens, NHS England’s Chief Executive, said: “Since its inception, The Cancer Drugs Fund has successfully enabled the funding of new cancer medicines for tens of thousands of patients in England. We want to build on that success by expanding funding again this year to enable cancer patients to access innovative effective new treatments.
“Within this extra funding we want to ensure the drugs provide maximum benefits to patients and that the CDF incentivises responsible pricing by drug companies. We want to create a sustainable Cancer Drugs Fund that will ensure patients don’t miss out on innovative treatments that are on the horizon.”
Mr Stevens has also asked Professor Clark to work with NICE, patient groups and the Association of the British Pharmaceutical Industry (ABPI) to develop options for ensuring greater alignment between CDF and NICE assessment processes. The CDF panel will also develop options for a new Evaluation through Commissioning scheme. This would allow the evaluation of the clinical effectiveness of promising new drugs, which are not currently supported by enough evidence to allow NICE to recommend they are made routinely available.
The CDF panel, comprising doctors, pharmacists and patient representatives, will review all available evidence for a number of drugs currently on the list. The panel’s decisions will be published in due course.”
Cancer Drug Fund article
“Sir Andrew Dillon, Nice chief executive, suggested in an interview with the Financial Times last week that, once the CDF expired, a new way should be found to evaluate drugs. This would potentially allow drugs to be launched for an interim period so that information could be gleaned about their effectiveness before a final price was agreed.” Financial Times – full article.
Having an interim decision – especially when NICE is unable to make a clear decision, due to uncertainties in the cost-effectiveness financial model – is something MDS UK has suggested at previous NICE appraisal meetings.
We therefore definitely welcome such a suggestion from Andrew Dillon – and hope this will be implemented as soon as possible. This would most certainly help to reduce delays and would help to gather the necessary practical evidence often missing with rare diseases and scarce trial data.
It may also help to rely less heavily on the current QALY system, which again is inadequate for scarce data.
A further NICE improvement would be to allow all stakeholders – clinical experts, patient experts and pharma – to be present at all NICE appraisal meetings – in order to provide additional expert information and reduce misinterpretations. Currently only the pharma industry is allowed to participate in all appraisal meetings.
Clinical experts – as well as patient experts are only allowed as public observers – after the initial NICE meeting.
* The CDF has now approved the use of lenalidomide for MDS del 5q patients with 1 more chromosomal abnormality.
NICE has now already approved lenalidomide for del 5q as a single chromosomal abnormality – see our previous News item here: NICE approves lenalidomide – 20/08/14
