Countries around the world should learn lessons from the NHS cancer drug funding scheme and avoid implementing similar initiatives, the authors warned.
The fund - scrapped in 2016 due to unsustainable financial pressure - aimed to provide patients with faster access to the most promising new cancer treatments. It sought to speed up evaluation and funding of new medications, and approved exceptional use of medications that had failed NICE appraisal.
It was replaced last year with a joint initiative between NHS England, NICE, Public Health England and the DH, which can no longer provide access to medications not recommended by NICE.
UK researchers looked at 29 drugs that had been approved for use through the CDF in January 2015 for 47 specific cancer indications. They found only 18 of the approved indications had significant evidence of improving patients’ overall survival, according to the study published in Annals of Oncology. This number further reduced when factors such as quality of life and toxic side effects of the drugs were taken into account.
Lead author Dr Ajay Aggarwal said: ‘The majority of cancer medicines funded through the CDF were found wanting with respect to what patients, clinicians and NICE would count as clinically meaningful benefit.’ NICE had previously rejected 26 out of 47 of the CDF-approved indications because they did not meet cost-effectiveness thresholds.
Fellow author Professor Richard Sullivan criticised the initiation of a ring-fenced drugs fund without evidence it would improve cancer patient care. ‘We recommend that other countries that are considering similar ring-fenced drug access funds for high-cost cancer drugs should adopt a more rational approach to funding high-cost health technologies.
Cancer drug fund
‘Our findings underline the importance of reimbursement decisions for all drugs, procedures and interventions in cancer care being made through appropriate health technology appraisal processes.’
A total of £1.27bn had been spent on the CDF over a six-year period by the time it closed in 2016.
The authors went on to condemn the CDF for failing to collect mandatory data about patient outcomes while they were taking the medication such as side effects, deaths after 30 days of treatment, date of death and date or relapse.
'We lost a major opportunity to understand how these medicines work in the real world,' said Prof Sullivan.
Photo: JH Lancy