Big Pharma Welcomes Extension to England's Cancer Drug Fund, Critics Unconvinced

The UK Prime Minister David Cameron has announced that the Cancer Drugs Fund (CDF) in England - which covers the cost of cancer treatments either when the National Institute for Health and Care Excellence (NICE) has said ‘no’, or hasn’t yet come to a view - will be extended to April 2016.

Why extend funding?
Not everyone has been a fan of the fund, which started with £50m and will now see £400m (US $642m) invested over the next three years; some have highlighted that it undermines NICE and doesn’t actually deal with the underlying problems that leads to NICE saying ‘no’.

But others have been keen to see it continue, and perhaps even go further. That includes companies like Novartis, Sanofi and Roche and patient organizations like the Rarer Cancers Foundation (RCF) who have been lobbying for continuation of the fund. It should be no surprise that the PM made his announcement at a RCF and Beating Bowel Cancer event.

Although speculation, the extension could simply reflect the fact that it allows Ministers to make statements about the ‘thousands’ of people that the fund has helped. And if Cameron is re-elected in 2015, he has said he’d recommend that the fund continued beyond 2016.

It’s also been suggested that the fund is being continued partly because there won’t be radical changes under value-based pricing (VBP), just a refined approach under NICE. That also means that there won’t necessarily be the much hoped for improved access to new medicines that prompted the fund in the first place. That presented the very real threat of more headlines about cancer patients being denied life saving drugs, and in the run up to the next General Election, which has been neatly side-stepped.

What will it buy?
The CDF is now managed centrally by NHS England and they have set out a list of what it currently covers.  Roche is reported to be a particular beneficiary of the fund.

The PM’s announcement suggests that the new £400 million will allow new patients to benefit and also “guarantee that those currently receiving drugs will continue to get them”.  But that might be difficult to do: some say that the fund is not enough and that funding pressures will mean that some products will have to be taken off the CDF list as new products become available.

What will be the challenges?
Just as before, this extension simply puts off the time that decisions will need to be made about the approach to those drugs that are either too expensive or where decisions are slow to be made by NICE, and how they will fit into the new approach to pricing and reimbursement.  The new approach will likely be some combination of the Pharmaceutical Price Regulation Scheme (PPRS) and VBP.  And we’re still waiting to find out the details for this as negotiations continue between Government and the Association of the British Pharmaceutical Industry (ABPI).

Even outside of the complexities of pricing and reimbursement, there are also those who ask just why cancer gets special treatment. That sentiment has been echoed by NICE.  Not only that, but just what is this funding actually buying in terms of health benefits?

Leela Barham is an independent health economist. You can find out more about on her website and contact her at leels@btinternet.com