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Cancer Drugs Fund – a challenge and an opportunity



The Government’s Cancer Drugs Fund is a real opportunity to improve patient access to innovative medicines and reverse the trend of the UK lagging behind other comparative countries in cancer treatment, according to the Association of the British Pharmaceutical Industry.

In its response to the Government’s consultation on the Cancer Drugs Fund, the ABPI makes clear its strong support for the fund but also emphasises the potential for it to worsen regional variations if the right mechanisms are not put in place to help patients gain equal access to cancer medicines not available on the NHS.

The ABPI also calls for close and transparent monitoring of how the Fund operates, to help identify other factors that need addressing to improve outcomes for cancer patients in the longer term, recognising that – while vital – money alone will not provide a sustainable solution.

The ABPI’s recommendations are backed by insights into the regional operation of the interim Cancer Drugs Fund.

While not conclusive, information collected during the first three months of operation does show a lack of regional consistency in access, transparency, timing of decisions, appeal mechanisms, clinical involvement and audit arrangements.

However, in some areas the interim CDF has achieved its objective of improved patient access and decision-making consistency. Key recommendations in the ABPI’s consultation response include:

  • A national framework from the Department of Health with a set of clear inclusion criteria so that those cancer medicines which should be paid for from the CDF can be quickly and easily identified
  • Department of Health detailed guidance to the NHS to ensure consistency in the implementation of the CDF across England and to minimise potential inequities and variability in access to cancer medicines
  • Patient representatives on local decision making panels and broader patient involvement in the Cancer Drugs Fund at a national level
  • Quarterly reports on how the Fund is operating to assess efficiency in meeting the needs of patients locally
  • Enabling monies to be transferred between NHS regions where a clear over or underspend is identified and for funds to be carried over from one financial year to the next if any surpluses remain.

Director General of the ABPI, Dr Richard Barker, said: “The Government has committed to the Cancer Drugs Fund until 2013. This provides a unique opportunity to improve patient access to cancer medicines. Together, patient representatives, the NHS, industry and Government must use this chance to identify potential barriers and remove them to improve outcomes for cancer patients in the UK.

“The ABPI and industry welcome the Cancer Drugs Fund as an important step forward in helping patients, but money alone cannot solve the complex issue of increasing access to cancer medicines in line with estimated patient needs. We need a clearer picture of what is happening on the ground so that sustainable solutions can be found and the UK leads rather than lags behind other countries in patient access to cancer medicines and survival rates.”

Dr Barker added that it must also be clear that the Cancer Drugs Fund is an addition to the current system, it does not replace the NICE approval process and that for patients to benefit, medicines must continue to be submitted to NICE for approval.

The ABPI recommends that the following categories of cancer medicines should be eligible for funding via the Cancer Drugs Fund with clear and tight criteria set out in a national framework and guidance. It is vital that the criteria are tight to avoid regional variations in local decision making but the ABPI is not in favour of a restricted national list of eligible drugs which would prove inflexible and a barrier to innovation. The categories the ABPI recommends are:

  • cancer medicines and specific indications for sub-groups of patients which have not been reviewed by NICE or have received a negative recommendation by NICE
  • cancer medicines and specific indications which are going through the NICE appraisal system but where final guidance has not yet been issued.

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