Cancer Drug Fund is ‘a victim of its own success’

When the Cancer Drug Fund launched in 2010 it was supposed to be a temporary measure which would allow cancer patients to be treated with cancer drugs their doctors thought would help, but had not been approved for use by the National Institute for Health and Care Excellence (NICE). Since then the Fund has been going through a rocky metamorphosis to get where it is today: a mainstream of cancer services in England that supports almost 1 in 5 patients starting a new chemotherapy treatment and a total lifetime budget of £1.27 billion.

In the first few years of the Fund, 2010-2013, there were large differences in access across England. In the East Midlands covering my Mid-Derbyshire constituency, the number of patients supported by the Fund per new cancer cases was 27, the lowest in the country, compared to 99 in South Central England. There was also incredible underspend with 28% (£128 million) of the budget not spent.

The other big failing was the lack of data collection. Originally the Department of Health recommended, but not required, the regional Health Authorities to collect data on patient outcomes. Considering the point of the Fund was to see how drugs not approved by NICE perform in practice, the lack of enforcement of data collection is baffling to me. It took five years, and a change in leadership, for an agreement to be made on tracking the outcomes of CDF patients. This is far too long and a huge lost opportunity to measure the efficacy of the drugs given to patients.

By contrast, today every new CDF patient is automatically identified on the Systemic Anti-Cancer Therapy (SACT) database which tracks outcomes.

The Fund has also gone from underspending to overspending. In 2013-2014 and 2014-2015 NHS England overspent the allocated budget for the Fund by 15% (£31 million) and 48% (£136 million) respectively. 

The Fund has become a victim of its own success. Understandably, doctors want to prescribe their patients the drugs they think will work, prolong life or put the cancer into remission. In the first year of operation the Fund dealt with 3,000 patients. In 2014-2015 this figure has jumped to over 20,000 patients. Unfortunately the more people that use it, the more expensive it has become leading to the CDF taking drugs off the its list to cut costs.

This action has hit the people the Fund was trying to help most. I understand the need to rein in costs but to hear from constituents who have had their hopes for treatment dashed is heart breaking and infuriating. For those in advanced stages of cancer some of the last chances to extend survival have been taken away and doctors are unable to prescribe drugs they would have been able to previously.

I am sure there are many more cases like this and I want the debate on the removal of drugs to be an opportunity for Members to raise the cases of constituents and debate the future of the Fund. The consultation on how it operates ends in February. I hope the CDF will continue to negotiate and work with drug manufacturers to reduce the prices and to have the drugs that were removed back onto the list and given the proper amount of time to establish their effectiveness.