The decision to hand adjudication on the future of drugs reimbursed by the first version of the UK’s Cancer Drugs Fund (CDF) to NICE was never going to see it sprint through its new appraisal workload.

Nevertheless, since publishing the first of its reassessments on which treatments could remain on the CDF, NICE has progressed at a decent pace and last week said it has now reached the halfway point.

What started with a positive recommendation last January for Astellas’ Xtandi in prostate cancer has certainly provided much work for the industry too.

So far, some 14 cancer drugs across 18 indications have been backed by NICE to stay on the CDF, but in all cases their manufacturers have either cut their prices or had to find new data with which to win NICE over.

Moreover, while no product has yet received a negative final decision, draft ‘no’s for Kadcyla, Adcetris and Erbitux will have put Roche, Takeda and Merck KGaA on notice.

But from NICE the message is that the system is working well. “The good news for patients,” said chief executive Sir Andrew Dillon, “is that more cancer drugs than ever are being recommended for routine use.”

The hoped for trade-off is, as Sir Andrew said, that as drugs are moved off the CDF funding should be freed up for newer drugs. However, given that no drug has actually been removed at this halfway point, it would appear that either the promise of new funding will prove to be an empty one, or those yet to be appraised should watch their backs.