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Introduced in 2010 by the coalition government as a short-term measure while pricing of medicines was reformed, the Cancer Drugs Fund has so far been extended and had more money pumped into it to cope with increasing demand. The fund was originally worth £200 million per year and was due to expire in March 2014. It is now guaranteed until March 2016 and is worth £280 million per year.
Despite this injection of funds, the Cancer Drugs Fund is still overspent and on Wednesday plans were revealed to reassess many of the drugs on the fund.
Some of the drugs are being reassessed because their clinical benefit is limited. While this is obviously unfortunate for patients who can benefit from those drugs, it is understandable that use of the fund should be restricted to those drugs that can provide the most clinical benefit. However, drugs are also being reassessed on grounds of cost, and it’s possible that some of the most effective breast cancer drugs will be removed from the fund because they are deemed too expensive.
Let’s be clear on this. The fund that was introduced to allow patients access to the drugs that the National Institute for Health and Care Excellence (NICE) can’t approve because of cost is now going to start removing drugs from their list because they cost too much. The Cancer Drugs Fund was only ever meant to be an interim solution, a safety net to allow access while a longer-term solution was developed. Now that cost is being introduced, the safety net is being ripped away while the longer-term solution has, as yet, failed to materialise.
All hope is not yet lost – pharmaceutical companies now have an opportunity to offer confidential discounts to the NHS to allow their drugs to remain on the Cancer Drugs Fund. We are of course hopeful that companies will rise to this challenge to ensure that the very effective drugs currently available on the fund remain available. However, there is no guarantee of this and at the moment it appears that NHS England and the pharmaceutical industry are engaged in a fierce game of chicken, with patients stuck in the middle.
It is important to remember that patients are at the heart of this. While we talk about price and assessment and cost-effectiveness, it’s all too easy to forget that it will be patients who lose out if these drugs are removed from the Cancer Drugs Fund. Patients who often have advanced forms of cancer who desperately need these drugs to give them more time with their families.
Patients are the reason that we need life-extending drugs to be available on the Cancer Drugs Fund, and patients are the reason that we need a long-term solution to the issue of access to cancer drugs in the UK.
There is a lot of talk about making the Cancer Drugs Fund ‘sustainable’. We seem to be forgetting that the Cancer Drugs Fund was never meant to be sustainable. It was a short-term fix for a long-term problem. The long-term solution is now long overdue and here at Breakthrough Breast Cancer, we won’t stop until we’ve got it.
Caitlin Palframan is Breakthrough’s Senior Policy Manager