NHS England is considering a trio of changes to the Cancer Drugs Fund, including, for the first time, taking a medicine’s price tag into consideration when determining whether it should be included or not.

The group has now launched a four-week public consultation to gauge opinion on three proposals to modify the way the CDF operates: a re-evaluation process so that drugs offering the lowest level of clinical benefit can be removed from the list; a confidential element to assess a drug’s cost versus its clinical benefit; and a new option enabling pharma companies to adjust prices to allow their drug/indication to remain in the CDF.

So that the CDF “continues to offer maximum benefit to patients within its budget, i.e. offer drugs with the greatest clinical benefit at appropriate costs, it requires a degree of change in the way it operates, in order that it can better meet the demand for new drugs,” NHS England said, noting that the Fund “is now facing growing financial pressure”.

Around 2,000 new patients currently gain access to the CDF every month, with rising demand driven by new drugs and new lines of therapy offering clinicians and patients additional treatment options. Against this backdrop, NHS England says  “urgent action” is needed to ensure it remains sustainable for the longer term.

Delivering 'value for money'

It claims clinicians and cancer specialists back the changes, noting that, if adopted, they would improve patient access to the drugs most clinically effective, encourage pricing “that delivers value for money”, and “put the fund on a much firmer footing for the future”.

But, while supportive of the changes, Chris Askew, chief executive of Breakthrough Breast Cancer, also recently pointed out that “this is not a long-term solution to the problem of access to drugs that currently exists in the UK”, where drugs, such as Roche’s Kadcyla (ado-trastuzumab emtansine), are rejected for routine use on the NHS due to their high cost. 

The consultation follows news in August that the government is investing an extra £80 million a year into the Fund, bringing the yearly total to £280 million. Currently the CDF is only set to run until March 2016.