Get information on what the Cancer Drugs Fund (CDF) is, who makes the decisions about which drugs are available, and how they decide.
What is the Cancer Drugs Fund?
The Cancer Drugs Fund (CDF) aims to make promising cancer drugs available to patients before they are fully approved for use in the NHS.
The CDF process changed in July 2016. It is now part of the National Institute for Health and Care Excellence (NICE) process that decides which cancer drugs are available on the NHS. The aim is that this will be an easier and smoother process than in the past.
The previous Cancer Drugs Fund (2010-2016)
The previous Cancer Drug Fund closed in July 2016. It was set up in October 2010 as a short-term solution to help reduce delays and improve patient access to new cancer drugs.
The old Cancer Drugs Fund (CDF) used money the government had set aside to pay for cancer drugs in England that hadn’t yet been approved by NICE. The money in this fund was originally £200 million and it increased to £340 million by 2016.
A review at the end of 2015 looked into how well the fund was working and decided that it was no longer working in the best interests of patients. It was also becoming increasingly expensive. The reviewers decided that how it was set up and managed should be changed.
The new Cancer Drugs Fund (2016 onwards)
The new Cancer Drugs Fund has become part of the NICE process for reviewing new cancer drugs. NICE now aims to review all new cancer drugs within 90 days of them being licensed for use in England. It also assesses drugs used to treat rare cancers. This is a new system because drugs for rare cancers weren’t always considered by NICE before 2016.
NICE now makes one of 3 decisions about whether a drug should be available:
- Yes - the drug should be routinely available on the NHS
- No - the drug should not be routinely available on the NHS
- Maybe - the drug can be made available via the Cancer Drugs Fund so that we can be sure how effective it is
A 'Yes' decision
When NICE initially say ‘Yes’ to a drug it goes into the CDF for a short period of no more than 90 days until the decision is confirmed. Once the NICE decision is confirmed it leaves the CDF and becomes routinely available. This now means that the drug is available immediately, which wasn't always the case before 2016.
A ‘No’ decision
A ‘No’ decision means that the drug doesn’t work well enough or doesn’t fulfil the value for money criteria set by NICE. So it is not approved for use in the NHS and can't be provided under the CDF.
A 'Maybe' decision
A ‘Maybe’ decision means that the drug shows promising results in trials but there isn’t enough evidence for a ‘Yes’ decision at the moment. This means that the drug could be recommended for observation in the CDF. There is then more time to collect evidence about how well the drug works and whether it meets the value for money criteria set out by NICE.
After a period of up to 2 years on the CDF, NICE reconsiders the drug and make a final ‘Yes’ or ‘No’ decision.
A drug will only be recommended for observation in the CDF if:
- it has potential to meet the value for money criteria
- the pharmaceutical company agrees to the terms of the CDF
- there is a way to collect information about how well it works or to fill in a gap which is stopping NICE from making a final decision
The aim is that doctors caring for people with cancer can still access the new treatment quickly for their patients.
How long it takes
Once a drug is licensed, NICE should make its ‘Yes, No or Maybe’ decision within 90 days. This might have taken much longer before. This means you can now get the drug quickly if you need it.
This should make it easier for you and your doctor to understand what is available.
A decision may also be made about how long a drug should stay on the Cancer Drugs Fund list. Most drugs will only stay on the CDF for a short period. Some drugs may stay for longer if doctors think they need to get more evidence about how well the drug works and whether it is value for money. Generally, it is a maximum of 2 years.
You can also see information about when the drug might be used. This might be:
- for a certain type of cancer
- for a certain stage
- only in advanced cancer
- only if other treatments have been tried first
Applying to the Cancer Drugs Fund
Your specialist applies to the Cancer Drugs Fund for you. They fill in a simple form online.
You can’t apply directly yourself. Your cancer specialist is in the best position to suggest what treatment is best for you. They make a decision based on:
- your type and stage of cancer
- any treatments you have had before
- your general health
As soon as your specialist submits the form they should get immediate confirmation that you can start the drug.
Scotland, Wales and Northern Ireland
The Cancer Drugs Fund is only available for patients in England who are entitled to routine NHS care and are registered with an English GP. Access to new medicines is different in Scotland, Wales and Northern Ireland.
The Scottish Medicines Consortium (SMC) aims to make sure that people have the same access to treatment wherever they live in Scotland. Scotland has its own ‘new medicines fund’. This fund pays for some medicines for patients with rare or end-of-life conditions.
The All Wales Medicines Strategy Group (AWMSG) also makes some decisions for the NHS in Wales. Generally it follows NICE decisions.
The Welsh Government has recently announced a New Treatment Fund for Wales. This fund aims to speed up patient access to new treatments.
Health and Social Care Services in Northern Ireland usually follow NICE decisions.
Your doctor can make an Individual Funding Request (IFR) if they think that a treatment is the best option for you but it isn't available on the NHS.
A national IFR system is run by NHS England, which provides all the funding for chemotherapy. Previously IFR’s for cancer drugs were managed by the Cancer Drugs Fund.
Coping if you can’t have a cancer drug
You might feel disappointed if your CDF request is refused and you can’t have the drug you would like. This can be very difficult to come to terms with. You might feel a range of emotions, including anger. Talk to your specialist about why funding was turned down for you.
You might also find it helpful to talk to your specialist about whether there are other treatments you can have. Researchers are often looking at new treatments in clinical trials.