This page explains how new cancer drugs are made available on the NHS, and has information about the Cancer Drugs Fund (CDF).
New cancer drugs on the NHS
A drug can only be widely used in the UK if it has been given a licence.
However, having a licence doesn’t mean a drug will automatically be available.
Before new cancer drugs are made available on the NHS they need to be assessed and approved by the relevant organisation for England, Scotland, Wales and Northern Ireland.
In England, the National Institute for Health and Care Excellence (NICE) produces guidance about which drugs should be available on the NHS.
NICE looks at how effective a drug is and how much it costs.
Based on its assessment, NICE can:
- recommend the drug for use on the NHS
- not recommend the drug for use on the NHS
- recommend the drug be made available through the Cancer Drugs Fund (see below)
If NICE recommends a drug for use on the NHS, the NHS must make arrangements to fund the drug.
In Scotland, the Scottish Medicines Consortium (SMC) advises NHS boards about new drugs. Like NICE, it looks at how effective a drug is and how much it costs.
SMC can make one of three decisions about a drug:
- accept the new drug
- accept with a restriction (for example, the drug can only be recommended in a particular group of patients with a condition)
- not recommend the drug
It SMC accepts a new drug, NHS boards are expected to make it available.
In Wales, all drugs recommended by NICE (see England, above) must be made available on the NHS.
The All Wales Medicines Strategy Group (AWMSG) makes recommendations about drugs that have not been assessed by NICE.
In Northern Ireland, the Department of Health reviews recommendations by NICE. Usually NICE's decision also applies in Northern Ireland.
The Cancer Drugs Fund
The Cancer Drugs Fund (CDF) was set up in 2010 to give people in England access to some cancer drugs not normally available on the NHS.
The fund underwent major changes in 2016. As a result, NICE can now recommend that promising new drugs be available through the CDF even though there is still uncertainty about their clinical effectiveness. During the drug’s time on the CDF, often for around two years, more evidence is collected on the drug. NICE then assesses the drug again and makes a final decision on its future use on the NHS.
A number of drugs to treat secondary breast cancer are available through this fund.
While the CDF covers England, the drugs on the fund also benefit people in Wales and Northern Ireland. In Wales, drugs on the CDF are covered by the New Treatment Fund, while the Northern Ireland Department of Health gives access to drugs recommended for use on the CDF.