The Cancer Drugs Fund has been a missed opportunity for the government, NICE and pharma, according to the former health minister Paul Burstow.
Speaking exclusively to PMLiVE, Burstow said the Cancer Drugs Fund (CDF), which since 2010 has paid nearly £1bn extra into the NHS to pay for new cancer medicines rejected by NICE, has not delivered results for either the industry or the NHS.
He said: “Really, we’ve gained no insight or learning from the dozens of drugs being funded within the scheme. The quid pro quo of paying for these treatments was that there was proper and systematic reporting and recording of real-world data, so that was then capable of being fed back into the NICE process for a final decision about whether that drug should, or should not, be available.
“But this hasn’t happened – and [data not being collected] is the main criticism coming from the National Audit Office and it’s clear to see that the CDF process has missed that opportunity.”
NICE has effectively been an observer of the Fund, with no information from its use coming back to the Institute. Burstow believes the watchdog should have been able to access these data to help it decide whether the oncology treatments it rejected were in fact worthy of gaining NHS funding.
He also questioned whether, instead of having a silo fund just for cancer, if the government “could have operated patient access schemes in the context of the CDF” – ie, allowing some of these medicines to be funded by having pharma offering discounts, rather than just paying out the full price from the Fund.
We’ve gained no insight or learning from the dozens of drugs being funded within the scheme
Burstow also asked whether the CDF should be just for cancer – or, in fact, just for drugs. He explained: “I would personally propose a ‘drugs and devices fund’ that was broader in its scope than just for cancer – it has to be an aid to bringing drugs to access at an earlier stage.
“But again, the quid pro quo has to be that there are processes put in place to ensure that what we learn from it is meaningful, and can then inform judgements at a later stage by NICE.”
Burstow was speaking to PMLiVE as two new reports from IMS Health and Abacus International – both commissioned by Janssen – were launched in Parliament this week.
They found that NICE is ‘slowing down access’ to new cancer medicines when compared to the rest of Europe, and suggested a reform of the body and the ways in which it assesses cost-effectiveness.
CDF ‘de-listing’ reprieve
Meanwhile, 16 drugs spanning 25 indications that were meant to be cut from the CDF’s approved list of treatments this week, but a number of companies appear to have won a reprieve at the eleventh hour.
Burstow admits that the de-listing process is evidence of the Fund being in a “difficult place” as NHS England, which manages the now £280m a year Fund, has been forced to cut the treatments as its struggles to find the money to pay for it.
But there has been something of a U-turn on some of these decisions, which were originally announced in January.
According to reports, NHS England will now allow Novartis’ Afinitor (everolimus) to remain on the funding list for two of the three indications for which it was due to be axed.
Eisai’s breast cancer treatment Halaven (eribulin) may also see a reprieve after it lodged an appeal against the decision. Lilly has in addition told PMLiVE that its cancer treatment Alimta (pemetrexed) may also be reinstated for some patients with non-squamous non-small cell lung cancer.
A final decision on the drugs, and a full approval list, should be published later this month.