The evaluation of drugs currently funded under the Cancer Drugs Fund (CDF) could be passed over to National Institute for Health and Care Excellence (NICE) under proposals drawn up by NHS England.
The new proposed model is expected to be more closely aligned with NICE processes. The proposals will be subject to consultation in September 2015, where it is anticipated that the new CDF will be operational from 1 April 2016.
“The emerging proposal is that in future the CDF should become a ‘managed access’ fund for new cancer drugs, with clear entry and exit criteria. It would be used to resource those drugs which appear promising, but where NICE indicates that there is insufficient evidence to support a recommendation for routine commissioning, and where additional evidence would be likely to enable a more informed NICE appraisal decision,” NHS England says.
Instead of a simple failure to recommend, the drug would be given “conditional approval” by NICE and provided through the fund for a defined period, whilst further evidence from “real world” use was collected, it adds.
At the end of this period, the drug would go through an abbreviated NICE appraisal, and then either attract a NICE positive recommendation or a negative one (at which point it would move out of the fund and become available only on the basis of individual patient referral).
The CDF was created in 2010 to pay for drugs that haven’t been approved by NICE, but despite increases from its original budget of £200m per year, its overspending has increased, resulting in the removal of 25 drugs from its list in March 2015 in an effort to save £80m.