NHS England, the National Institute for Health and Care Excellence (NICE), Public Health England and the Department of Health have launched a new approach to the appraisal and funding of cancer drugs in England. The new system became operational on 29 July 2016, and replaces the Cancer Drugs Fund (CDF), which closed on 31 March 2016. From 29 July, a number of drugs will be eligible to receive interim funding, including everolimus for the treatment of metastatic kidney cancer.

View the latest national Cancer Drugs Fund (CDF) list here.

Kidney Cancer Support Network (KCSN) contributed to the 12-week consultation period for the new appraisal/CDF system, which took place earlier this year. KCSN is also a member of the charity coalition set up to monitor the new proposed system of appraising cancer drugs. Following the public consultation and the numerous discussions, teleconferences and face-to-face meetings that have taken place, the new system for appraising and funding cancer drug is now operational. However, there is still uncertainty as to how the system will work in practice. Our hope, of course, is the changes will lead to quicker access to new medicines and we will be monitoring the situation carefully to assess the impact of access to kidney cancer treatments.

Key features of the new system include:

  • All cancer drugs/indications expecting to receive a marketing authorisation (license) will now be appraised by NICE;
  • Early funding option available, through new interim funding arrangements, for those drugs given either a NICE draft recommendation for routine commissioning use, or a NICE draft recommendation for use within the CDF;
  • Clear entry and exit points for drugs in the CDF;
  • Managed Access Agreements between NHS England and pharmaceutical companies, setting out the terms of a drug’s entry into the CDF and the means by which data will be collected to resolve any uncertainty relating to a drugs clinical and cost-effectiveness;
  • All eligible patients to receive CDF drugs, not just the number of patients needed to resolve uncertainty;
  • Expenditure control mechanism to reduce risk of overspend and ensure the fund never needs to close to new entrants;
  • A new, joint NHS England/NICE CDF Investment Group to manage the overall CDF budget;
  • Similar opportunities for off-label drugs to gain access to CDF funds, if deemed to show clinical promise.

What does the new system mean for patients?

  • Faster access to the most promising new treatments
  • Clearer, faster decision-making, meaning less uncertainty about a drug’s availability
  • Similar opportunities for off-label drugs/indications – often used to treat rarer cancers – to obtain CDF funding
  • Access to CDF-funded drugs for all eligible patients
  • Any drugs that were in the CDF as of 31 March 2016 will continue to receive funding while awaiting reconsideration or appraisal by NICE
  • All patients currently receiving treatment via an existing CDF drug will continue to do so, regardless of the outcome of any NICE appraisal or reconsideration, until their clinician decides otherwise

Read more about the new appraisal/CDF system on the NHS England website.

Cancer52, an alliance of 90 organisations representing rare and less common cancers, has written a position paper on the new CDF operating model.

We are very keen to hear your feedback and experiences regarding access to treatments over the coming months.