Which anticancer drugs need special funding to be prescribed?

Many breast cancer drugs, including chemotherapies, hormone therapies and trastuzumab are available as standard on the NHS. Your oncologist can prescribe these drugs to you without needing to seek special funding or permission.

However, some anticancer drugs (including some of the newest drugs) are not routinely available on the NHS. Drugs that require a special funding request include:

  • Bevacizumab (Avastin), which is used in combination with chemotherapy, or when chemotherapy is not suitable
  • Lapatinib (Tyverb), to treat HER2+ cancer alongside other drugs
  • Fulvestrant (Faslodex), which is used in post-menopausal women with ER+ breast cancer that has started to grow again after tamoxifen treatment

  • Pertuzumab (Perjeta), to treat HER2+ cancer alongside trastuzumab and docetaxel chemotherapy
  •  Lapatinib (Tyverb), to treat HER2+ cancer alongside other drugs
  • Trastuzumab emtansine (Kadcyla), which is used in patients with HR2+ cancer that has started to grow again after trastuzumab and taxane chemotherapy
  • Fulvestrant (Faslodex), which is used in post-menopausal women with ER+ breast cancer that has started to grow again after tamoxifen treatment
  • Everolimus (Afinitor), which is used with exemestane (Aromasin) in post-menopausal women with ER+ breast cancer that has started to grow again after treatment with anastrozole (Arimidex) or letrozole (Femara)
  • Bevacizumab (Avastin), which is used in combination with chemotherapy, or when chemotherapy is not suitable
  • Eribulin (Havalen), which is used when secondary breast cancer has started to grow again after anthracyclines and taxanes, or when these chemotherapies are not suitable

  • Pertuzumab (Perjeta), to treat HER2+ cancer alongside trastuzumab and docetaxel chemotherapy
  • Trastuzumab emtansine (Kadcyla), which is used in patients with HR2+ cancer that has started to grow again after trastuzumab and taxane chemotherapy
  • Fulvestrant (Faslodex), which is used in post-menopausal women with ER+ breast cancer that has started to grow again after tamoxifen treatment
  • Bevacizumab (Avastin), which is used in combination with chemotherapy, or when chemotherapy is not suitable
  • Eribulin (Havalen), which is used when secondary breast cancer has started to grow again after anthracyclines and taxanes, or when these chemotherapies are not suitable
  • Lapatinib (Tyverb), to treat HER2+, which is available on the NHS but only alongside certain drugs

  • Pertuzumab (Perjeta), to treat HER2+ cancer alongside trastuzumab and docetaxel chemotherapy
  • Lapatinib (Tyverb), to treat HER2+ cancer alongside other drugs
  • Trastuzumab emtansine (Kadcyla), which is used in patients with HR2+ cancer that has started to grow again after trastuzumab and taxane chemotherapy
  • Fulvestrant (Faslodex), which is used in post-menopausal women with ER+ breast cancer that has started to grow again after tamoxifen treatment
  • Everolimus (Afinitor), which is used with exemestane (Aromasin) in post-menopausal women with ER+ breast cancer that has started to grow again after treatment with anastrozole (Arimidex) or letrozole (Femara)
  • Bevacizumab (Avastin), which is used in combination with chemotherapy, or when chemotherapy is not suitable
  • Eribulin (Havalen), which is used when secondary breast cancer has started to grow again after anthracyclines and taxanes, or when these chemotherapies are not suitable

Your oncologist can explain the likelihood of you getting funding for a prescription and explain the process for this.

How can I find out if one of these drugs is suitable for me?

Your oncologist is the best person to advise you on whether any of these drugs are suitable for you. This will depend on many factors, including:

  • The characteristics of your cancer cells
  • Which treatments you’ve had before
  • How well those treatments worked for you
  • Where in your body your cancer has spread
  • Your general health

How can I request a prescription of one of these drugs?

If your oncologist believes that a drug not available as standard on the NHS would be particularly good for your treatment, they can request special funding for you. This is called an Individual Funding Request. Your oncologist will make the request to the NHS Commissioning Board, which is the part of the NHS that makes decisions on which health services are available across England. Not all Individual Funding Requests are successful – you may want to discuss your next best option with your oncologist, so you’re prepared if your request is rejected. A panel of people will consider your Individual Funding Request. They’ll be looking to see how your case is unique and why you would benefit more from the drug than most people with breast cancer like yours. They’ll also consider whether the NHS can afford to pay for the drug.

If they approve your request, your oncologist will be able to prescribe the drug to you. If your Individual Funding Request is not successful, your oncologist won’t be able to prescribe the drug for you. You can request that the panel’s decision is reviewed with the support of your oncologist.

If your oncologist believes a drug not available as standard on the NHS would be particularly good for your treatment, they can request special funding for you. This is called an Individual Patient Treatment Request and is made to your local Health Board.

Not all Individual Patient Treatment Requests are successful – you may want to discuss your next best option with your oncologist, so that you’re prepared if your request is rejected. A panel of people will consider your Individual Patient Treatment Request. They will consider your medical needs and the benefit you could gain from the drug to help them decide whether to approve funding for you.

If they approve your request, your oncologist will be able to prescribe the drug for you. If your Individual Funding Request is not successful, your oncologist won’t be able to prescribe the drug for you. You can appeal the decision, with the support of your oncologist.

If your oncologist believes a drug not available as standard on the NHS would be particularly good for your treatment, they can request special funding for you. This is called an Individual Patient Funding Request and is made to your local Health Board.

Not all Individual Patient Funding Requests are successful – you may want to discuss your next best option with your oncologist, so you’re prepared if your request is rejected. A panel of people will consider your Individual Patient Funding Request.

They’ll be looking to see how much you personally could benefit from the drug, how well it works, and its cost. If they approve your request, your oncologist will be able to prescribe the drug for you. If your Individual Patient Funding Request is not successful, your oncologist won’t be able to prescribe the drug for you. You can request a review with the support of your oncologist – there are set rules for this.

If your oncologist believes a drug not available as standard on the NHS would be particularly good for your treatment, they can request special funding for you with the support of a Trust Senior Manager or Clinical Director. This is called an Individual Funding Request and is made to the Health and Social Care Board of Northern Ireland.

Not all Individual Funding Requests are successful – you may want to discuss your next best option with your oncologist, so you’re prepared if your request is rejected. A panel of people will consider your Individual Funding Request. They’ll be looking to see how your case is unique and why you would benefit more from the drug than most people with breast cancer like yours.

If they approve your request, your oncologist will be able to prescribe the drug for you. If your Individual Funding Request is not successful, your oncologist won’t be able to prescribe the drug to you. Your oncologist can request a review of the decision.

Alternatively, if they have more evidence that might help support your case, they can submit a new request for you.

Tips and advice

Advice on getting the best care

To help you feel confident you’re getting the best care, you may want to:

  • Ask your oncologist if any drugs not available as standard on the NHS would be particularly useful for your treatment
  • If so, ask if they can support you by making a funding request
  • Ask them to explain how long the request may take to be considered and the likelihood of it being successful

Information StandardInformation last reviewed: October 2015

Breast Cancer Now's health information is covered by NHS England's Information Standard quality mark. Find out how this resource was developed.