The Cancer Drugs Fund (CDF) is an England-only scheme which gives patients access to some cancer drugs not routinely available on the NHS.
The previous CDF ended on 31 March 2016. Following a public consultation on proposals for a new CDF, a new model came into effect today.
Here, we give an overview of the new CDF, what it could mean for you, and what Breast Cancer Care is doing to ensure the new model works for people with breast cancer.
How did we get here?
The CDF was set up in 2010 to give patients in England access to expensive cancer drugs that were not routinely available on the NHS. The CDF was planned to run for three years, during which time changes would be made to improve the system for assessing and making these drugs available.
Attempts to reform the system were unsuccessful. In September 2013, it was announced that the CDF would be extended until March 2016. Over the years, more and more patients accessed drugs through the CDF, and the budget was increased. However, from 2013-14 onward, the CDF overspent its budget. In January 2015, NHS England took steps to manage this overspend, which included removing some drugs from the CDF.
In December 2015, NHS England and the National Institute for Health and Care Excellence (NICE) put forward proposals for a new CDF model. This aimed to make cancer drugs available to patients while keeping the CDF within a fixed budget of £340m. This is the new model that launched today.
What could the new CDF mean for me?
The new CDF will still give patients in England access to some cancer drugs which are not routinely available on the NHS. The process for accessing drugs through the CDF remains the same as under the previous model.
There is a single, national list of all the drugs and indications currently available through the CDF. (One drug can be used to treat multiple cancer types, and these different uses of the drug are called its indications.)
Clinicians apply for drugs on behalf of their patient, using an online system. If the patient meets the criteria (their situation fits with the use of the drug), the application will be approved and the patient will have access to the drug.
The changes won’t have any impact on the availability of breast cancer drugs which are routinely available on the NHS. All drugs for primary breast cancer are currently available for routine use on the NHS.
We are monitoring the situation but drugs that may be affected by the changes are the following drugs used to treat secondary (metastatic) breast cancer:
- trastuzumab emtansine (Kadcyla or TDM-1)
- eribulin (Halaven)
- pertuzumab (Perjeta)
- everolimus (Afinitor).
These drugs may be affected because all drugs which were on the previous CDF will be reassessed by NICE using new criteria. Until they have been reassessed, these drugs will remain available to patients.
The outcome of these reassessments could be:
- The drug remains on the CDF and is available to patients.
- The drug is approved for routine use on the NHS and is available to patients.
- The drug is removed from the CDF and is only available to patients through a successful Individual Funding Request (IFR). Access through an IFR can be limited and is not guaranteed. You can find out more about this through NHS England’s patient guide to IFRs.
We will be monitoring any changes to the availability of these drugs. If a drug is removed from the CDF after being reassessed, NHS England will give two months’ notice. Anyone receiving the drug at the time will continue to have access to it after it is removed, but it will be unavailable to new patients after the two-month window.
A positive feature of the new CDF is the potential for patients to have earlier access to new cancer drugs, before they receive a full assessment by NICE (called a Technology Appraisal).
Apart from the potential for earlier access, there is little change to the way patients will access drugs through the CDF. However, the way the CDF works ‘behind the scenes’ is very different to before. Drugs will be funded for a limited period of time through the CDF. This is because the CDF will now be used by NICE as a further ‘testing ground’ for new cancer drugs. It is intended that more evidence can be collected about how well a drug works while it is on the CDF, to enable NICE to decide whether to approve it for routine use on the NHS.
What we're doing and how you can get involved
NHS England’s guide to the new CDF has been published, but it is still to be seen whether the new model works in practice.
We’ll be monitoring the implementation of the new CDF, and its impact on patients accessing drugs, over the coming year. We’re pleased that NHS England has committed to an evaluation of the new CDF by no later than autumn 2017. We will be looking to feed into this, to ensure that this evaluation looks at what matters to patients.
We’ll keep you updated on developments with the CDF through this blog and our Campaigns Network.
We’re here for you
If you have any concern about treatment options or are unclear what the changes may mean for you call us free on 0808 800 6000.