Access to cancer medicines in England will become worse than in the rest of Europe if special funding is not secured after the Cancer Drugs Fund (CDF) comes to an end in March 2014, according to 82% of oncologists in England questioned for a new survey.And the government should extend the CDF to ensure continued access to cancer therapies for patients while a new system of drug pricing is worked out, according to 76% of the 200 oncologists questioned for the survey. Without a clear transition to alternative arrangements, it is estimated that more than 16,000 patients a year would be denied access to potentially life-extending drugs, the survey points out.
Since the CDF was launched in April 2011, over 21,000 patients in England have benefitted from treatments they would otherwise have been denied, and oncologists have gained access to 35 additional drugs or indications as a direct result of the Fund, according to the survey, which was conducted by research firm Adelphi for Roche Products.Two-thirds of the clinicians said they believe the CDF was the right approach to improving access to cancer therapies in England, with 91% agreeing that action was needed. A minority felt that a national approach would have been fairer, but there is currently no equivalent programme in Wales or Scotland, meaning that patients in Wales are five times less likely to get access to a new cancer drug, and three times less likely in Scotland, says the firm.
“The CDF has given access to new anticancer drugs which are part of what is referred to as targeted therapy or, more recently, stratified medicine," commented David Ferry, professor of medical oncology at New Cross Hospital, Wolverhampton.
He welcomed the fact that, because of the Fund, clinicians “can use these drugs outside clinical trials in ordinary NHS patients, in every hospital where cancer patients are treated.""For years, Britain led in the development of these drugs and then we watched the rest of the world adopt the technology as our patients were left behind. Sometimes, the simple, low-bureaucracy ideas work best, and the CDF falls into that category," said Prof Ferry. He added: "it has of course required the often-unpaid input of devoted NHS consultants to make decisions and run the regional committees, so let's hope that spirit and utility is not destroyed by government-led centralisation."
95% of the oncologists said that they had made at least one application through the CDF and over half stated that all of their applications had been successful. In addition, almost one in 10 said they had treated at least one patient with a drug from the Fund.
"Many of the applications made through the CDF have been for patients with rarer cancers, particularly rarer blood and kidney cancers, which affect thousands of people in the UK," said Rarer Cancers Foundation chief executive Andrew Wilson, commenting on the survey findings."The CDF has provided many of these patients with access to treatment options that were not previously available to them," added Mr Wilson, but he warned of the risk that "access to treatment will go backwards, returning us to the dark days of cancer drugs being denied to the patients who need them."
"The government needs to reassure patients that it is not paving the way for the abolition of the CDF by stealth, putting in place the same legal safeguards that apply to [National Institute for Health and Clinical Excellence]-approved drugs," he said.94 different medicines have been funded through the CDF, and by March 2014 it is estimated that 44,000 patients will have benefited from the initiative, the survey notes.