If your oncologist recommends a medicine or treatment that is not available routinely via the NHS, you may still be able to access that treatment using another method.
If it is for a medicine, your clinician can make an application for the treatment to be funded through the Cancer Drugs Fund (CDF). Please note this route is only available to patients resident in England.
If you live in Northern Ireland, your clinician will need to submit an Individual Funding Request (IFR) to your local Health and Social Care Trust. In Scotland, your clinician will need to submit an Individual Funding Request (IFR) to your Local Health Board. If you live in Wales, your clinician will need to submit an Individual Patient Funding Request (IPFR) to your Local Health Board (see below).
Disclaimer: Our website provides general information only, and none of the information contained within our site shall be deemed to constitute medical advice in any way. You should seek appropriate medical advice or guidance from your doctor or health care team in relation to any medical condition.
Cancer Drugs Fund (CDF) – England only
Cancer patients living in England may benefit from the Cancer Drugs Fund (CDF), which was formally launched in April 2011. The CDF was established to enable cancer patients to access drugs that their doctors think will help them, but which are not routinely available within NHS England.
The CDF was revised in July 2016 and a new approach to the appraisal and funding of cancer medicines in England began operating. This new approach provides:
- Access to promising new treatments while further evidence is collected to address any clinical uncertainties
- Interim funding for all newly recommended cancer medicines, giving patients access to these treatments many months earlier than before.
NHS England and the National Institute for Health and Care Excellence (NICE) work in partnership with pharmaceutical companies to collect further evidence to address any uncertainties about the effectiveness of new cancer treatments. This usually involves the collection of additional data, during a managed access period when patients are able to access the treatment. The additional data helps NICE to decide whether a new treatment should be routinely funded on the NHS. The new approach provides earlier access to treatments.
What does the CDF mean for patients?
- Faster access to the most promising new treatments
- Clearer, faster decision-making, meaning less uncertainty about a medicine’s availability
- Similar opportunities for off-label medicines/indications, often used to treat rarer cancers, to obtain CDF funding
- Access to CDF-funded medicines for all eligible patients
- Those medicines given a conditional recommendation will be made available to NHS patients and paid for by the CDF.
The medicine will remain available within the CDF for up to 2 years while the manufacturer gathers more evidence to show that it works and is fairly priced. After 2 years, NICE will conduct a review, using a shortened process, to consider the medicine for routine commissioning on the NHS. This will either result in the medicine moving out of the CDF and into routine funding, or, if the manufacturer has not been able to demonstrate its case, made available on an exception basis only.
Further details and full guidance on the operation of the CDF can be found here.
Click here to see the latest CDF List.
Please contact us at any stage for clarification on the CDF process, as we appreciate it can be very confusing.
Only funding for cancer medicines is available via the CDF. If your oncologist recommends a treatment that is not a medicine, such as a specialised radiotherapy (proton beam therapy, selective internal radiotherapy or stereotactic body radiotherapy) the process is slightly different. Your oncologist will need to submit an Individual Funding Request (IFR) to the NHS:
Individual funding requests (IFRs)
Individual Funding Requests (IFRs) are made to local Clinical Commissioning Groups (CCG) in NHS England by clinicians when they believe that a patient’s clinical circumstances are exceptional and because of this, they would benefit from a treatment that isn’t usually available on the NHS. Applications are considered by an independent panel made up of doctors, nurses, public health experts, pharmacists, NHS representatives and lay members.
More information about the NHS England IFR system, and how to apply, can be found on the NHS England website. A guide for patients is available. Similar schemes are available in Scotland, Wales and Northern Ireland:
Each Clinical Commissioning Group in England or Health Board (in Scotland, Wales or Northern Ireland) should be able to provide the rules and process for applying for an IFR. However, the CCG or Health Board may choose not to fund the treatment even if a doctor believes it might help.
If you would like help with an IFR, please contact us.
Early Access the Medicines Scheme (EAMS)
The Early Access to Medicines Scheme (EAMS) aims to make promising new medicines available to patients sooner. It was started in March 2015, and it is a process to give patients access new medicines that are not yet licensed for use in the UK.
EAMS is run by the Medicines and Healthcare Products Regulatory Agency (MHRA), the government organisation that ensures the safety and effectiveness of all medicines and healthcare devices on the market in the UK. The MHRA approves product licenses (marketing authorisation) for all new medicines or new indications for existing medicines, allowing them to enter the UK market.
If a medicine has not been licensed, or recommended for use on the NHS, there may be some uncertainties about how safe and effective it is, and what side effects it might cause. For EAMS drugs, clinical trials might still be ongoing to gather more information about side effects and how well the medicine works, or the medicine may be waiting to be approved by the MHRA for a product license.
Clinical research and the licensing process can take many years. In addition, all medicines need to be recommended for use on the NHS before a doctor can prescribe them. The National Institute for Health and Care Excellence (NICE) carries out this process in England, the Scottish Medicines Consortium (SMC) in Scotland, and the All Wales Medicine Strategy Group (AWMSG) in Wales. These organisations decide whether the medicine works better than available treatments and represents value for money for the NHS, and can take many months to complete.
During the time that a new, promising medicine is undergoing approval for a product license or recommendation for use on the NHS, it is not available to patients, unless it can be accessed through the Cancer Drugs Fund (in England only). EAMS provides patients access to these medicines while the licensing/recommendation processes are ongoing.
EAMS can also be used to give doctors information to support a decision to prescribe a medicine off-label i.e. for a condition, age group or dose that it is not licensed for.
EAMS can only be used for medicines that may benefit people with a life threatening or seriously debilitating condition when there is no other treatment available to them.
To get access to a medicine that is in the EAMS, please talk to your oncologist to see if the drug is suitable for your situation. If your oncologist agrees that you might benefit from the EAMS medicine, they will make an application to the Department of Health (DH) in your local area.
If you are not able to access an EAMS medicine, it can be very disappointing. Please talk to your doctor about how you are feeling and why you are not able to have the treatment. Please contact us for more information about EAMS.
Compassionate use programmes
Compassionate use programmes allow the use of unauthorised or unlicensed medicines for patients for which there are no licensed treatments available, and who are unable to enter a clinical trial. They are intended to allow patients access new treatment options that are still under development. Your doctor will be able to advise you more specifically if this is an option available to you. Access to medicines via compassionate use programmes usually ends once the medicine receives a product licence.
The Medicines and Healthcare Regulatory Agency (MHRA) provides guidance on the compassionate use of medicines in the UK.
Named patient supplies
In some cases doctors may approach a manufacturer directly to request the supply of a new medicine that does not have a UK product licence to be used for a patient under their direct responsibility. This is often called supply on a “named patient basis”. Named patient supplies are more informal arrangements between the pharmaceutical company and the prescriber.
Read more about named patient programmes here
If you are unable to access the treatment your doctor wishes to prescribe by any of the means detailed above you may wish to consider ‘co-payment’ or ‘topping up’.
Co-payment involves paying for a treatment and any costs related to giving that treatment whilst still continuing with your NHS treatment you would otherwise receive. If this is something you wish to consider you should discuss this option in detail with your clinician.
Please do contact us for further assistance if you have been recommended a treatment that you are told is not routinely available via the NHS.
Updated February 2022