Cancer Drugs Fund 'was not fit for purpose'
28th April 2017 – England's Cancer Drugs Fund was not good value for taxpayers, failed to benefit patients and may have resulted in some experiencing toxic side effects from drugs, a report has concluded.
The fund was set up by David Cameron's Conservative government in 2010 in response to criticism that the UK lagged behind other western countries in treating cancer. It was designed to help patients access cancer drugs not available through the NHS, because the drugs had not been appraised, were in the appraisal process, or were not yet recommended by the NHS rationing body, the National Institute for Health and Care Excellence (NICE).
Costing £1.27 billion
The Cancer Drugs Fund (CDF) ran until 2016. It had an initial budget of £50 million a year. However, costs escalated and the budget rose to £200 million in 2013/2014, £280 million in 2014/2015 and £340 million in 2015/2016.
In July 2016, the CDF became a 'managed access fund', providing access to new cancer drugs for a limited period of time when the clinical and cost effectiveness of a drug is judged by NICE to be uncertain.
During its 6-year lifetime, the fund cost the taxpayer £1.27 billion, the equivalent of a year's total spending on cancer drugs by the NHS.
How effective were the drugs?
In a study published in the journal Annals of Oncology, a research team led by Dr Ajay Aggarwal, academic clinical oncologist at the London School of Hygiene and Tropical Medicine and Professor Richard Sullivan, director of the Institute of Cancer Policy at King's College London, examined the outcomes from 29 drugs that had been approved for use through the CDF up to January 2015 for 47 indications.
They found that only 38% of the drugs on the list were backed by clinical trials that showed a meaningful boost to patient survival.
These drugs meant that patients could expect to live for an extra 1.4 to 15.7 months, with an average extended survival time of 3.1 months, says the report.
The researchers say that when they considered other factors such as quality of life and toxic side effects of the drugs, the majority failed to show they had delivered meaningful value to NHS cancer patients.
They say this was borne out when in 2015, the committee managing the fund delisted more than half (51%) of the drugs, although some of these were later reinstated.
Costs of medicines
In an accompanying editorial, Dr Kapil Dhingra, associate editor of Annals of Oncology, argues that the cost of cancer drugs is relatively low in the US and Europe, representing less than 1.5% of the overall healthcare costs. "This does not mean that we can stay passive in the face of rising healthcare costs," he says. "Rather, it argues for the continuing need for a thoughtful analysis and discussion of the key drivers of the cost and designing necessary improvements to ensure that society as a whole can benefit from the investments that it is making in biomedical innovation."