Countries considering quarantining funds to provide faster access to expensive cancer drugs have been warned – the UK experiment failed.
Set up in 2010 with a budget of £50 million per year, the Cancer Drugs Fund (CDF) ended up costing the NHS £1.27 billion and failed to deliver ‘meaningful value’ to cancer patients or society.
The Fund, established to provide access for cancer drugs not approved by the National Institute for Health and Care Excellence (NICE) was ‘rationalised’ back into NICE last year.
A review of the initiative has been scathing. It found:
- evidence of overall survival benefit for only 18 of the 47 indications (38%) approved.
- less than half of the approved indications met ASCO (48%) or ESMO (18%) criteria for clinical benefit.
- 26 of the 47 CDF approved indications (55%) had previously been rejected by NICE for not meeting cost effectiveness criteria.
- and an internal CDF review process subsequently overturned 51% of its own approvals.
“The CDF was created following intense public and political pressure to provide access no matter what the cost or the evidence for their benefit,” the Annals of Oncology review said.
The fiasco raised questions of ‘value, distributive justice, and fairness’ considering funds were displaced from elsewhere in the NHS.
The reviewers said investment was required not just in cancer medicines but throughout the whole cancer management pathway including screening, diagnostics, radiotherapy and surgery.