Proposed changes to the way the Cancer Drugs Fund is run in England are to go ahead so that, for the first time, the cost-effectiveness of medicines on the list will be evaluated, putting some at risk.

According to NHS England the shake-up of the current system - which has seen the CDF run over budget - will mean more effective and promising drugs will be prioritised and made available to patients.

But forty-two medicines - including six for breast cancer, six for colorectal cancer and six for lymphoma - now face being de-listed from the Fund, having been picked for re-evaluation because of their high price. Patients already taking these drugs are, however, being reassured their treatment will not be discontinued.

On the plus side, 12 new drugs now have a shot at being included on the list, including Eisai’s Halaven (eribulin) as a second line treatment of metastatic breast cancer, and Roche’s Avastin (bevacizumab) as a second line treatment for platinum resistant advanced ovarian cancer.

Since it was established in 2010, more than 55,000 patients have accessed treatment through the Fund. Caitlin Palframan, Senior Policy Manager at Breakthrough Breast Cancer, said “it’s encouraging to see that changes are being made to improve the way that the CDF operates and make better use of the money available”.

Deep concern

But she also voiced “deep concern” that several effective breast cancer drugs are at risk of delisting due to their high price, as the Fund is “the only way women in England can routinely access these drugs that can offer them months, or even years, of additional good quality life”.

The charity is calling on all political parties to come up with a long-term, national solution to the ongoing problem of access to life-extending drugs by the end of the next parliament, “working with the pharmaceutical industry and key stakeholders to develop and embed a new system of drug pricing and evaluation”.  

According to Owen Sharp, Chief Executive of Prostate Cancer UK, “the huge deficit that has brought the CDF to the brink is the result of a failed drug appraisal system that continues to deny thousands of cancer patients access to effective drugs that they clearly need”.

He also calls for a long-term solution that delivers an overhaul of the way new cancer drugs are appraised. “There must be greater collaboration with the pharmaceutical industry to develop measures that combat the over-pricing of new cancer drugs and make them affordable for the NHS,” he stressed.