The Cancer Drugs Fund (CDF) is a way of funding cancer drugs in England.
What is the Cancer Drugs Fund?
The Cancer Drugs Fund (CDF) aims to make promising cancer drugs available to you. This is before the National Institute for Health and Care Excellence (NICE) approve them for use in the NHS.
The CDF process changed in July 2016. It is now part of the 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. And that you will have access to these treatments earlier than before.
The previous Cancer Drugs Fund (2011-2016)
The former CDF closed at the end of July 2016. It was set up in April 2011. Its aim was to be a short-term solution to help reduce delays and improve patient access to new cancer drugs.
The former CDF used money the government had set aside. This money had to pay for cancer drugs in England that hadn't yet been approved by NICE. The money in this fund was originally £200 million. It increased to £340 million by 2016.
A review at the end of 2015 looked into how well the fund was working. The reviewers decided that it was no longer working in the best interests of patients. The reviewers agreed that a change was necessary to the way it was set up and managed.
The new Cancer Drugs Fund (2016 onwards)
The new CDF 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 getting a licence for use in England.
It also assesses drugs used to treat rare cancers. This is a new system. NICE didn't always consider drugs for rare cancers 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
- Recommended for use within the CDF - the drug can become available via the Cancer Drugs Fund so that we can be sure it is effective
A 'Yes' decision
When NICE 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. It then becomes routinely available. This now means that the drug is available immediately. This wasn't always the case before 2016.
A ‘No’ decision
A 'No' decision means that the drug doesn't work well enough. Or it 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 'Recommended for use within the CDF' decision
Recommended for use within the CDF 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. Reviewers can also decide 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 makes a final 'Yes' or 'No' decision.
The aim is to still give doctors quick access to new treatments for their patients.
How long it takes
Once a drug has a licence, NICE should make its 'Yes, No or Recommended for use within the CDF' decision within 90 days.
This might have taken much longer before. It 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 remain in 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 they have tried other treatments 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 yourself directly. 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
Once your specialist has submitted the form, they will get confirmation that you can start the drug.
Scotland, Wales and Northern Ireland
The Cancer Drugs Fund is only available for patients in England. You have to be entitled to routine NHS care. You also have to be registered with a GP in England. Access to new medicines is different in Scotland, Wales and Northern Ireland.
In Scotland, there is the Scottish Medicines Consortium (SMC). It 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). This is if they think that a treatment is the best option for you, but it isn't available on the NHS.
NHS England runs a national IFR system. It provides all the funding for chemotherapy. Before, the Cancer Drugs Fund managed IFR's for cancer drugs.
Coping if you can’t have a cancer drug
You might feel disappointed if you can’t have the treatment you would like. This can be very difficult to come to terms with. You might feel a range of emotions, including anger.
It can be helpful to talk to your specialist. Ask them whether there are other treatments you can have or if you can take part in a clinical trial.
You might be able to talk with other people who have tried to get the same treatment. It can be helpful to share experiences.