Management of NHS expenditure on cancer drugs has improved due to the new Cancer Drugs Fund model

Written by Dorinda Hickey on Friday 29th June 2018

At this week’s NICE meeting in Manchester it was declared by David Thomson that the new Cancer Drugs Fund (CDF) is now operating within its funding envelope.  Dr Linda Landells also confirmed that the new CDF model has retained the best elements of the old fund ie. rapid access to new drugs, and removed the less desirable elements ie. the inclusion of drugs that are not cost effective and the overspend. 

The objectives of the new CDF model are to deliver patient access, value for money and provide a fast track route to the best drugs that are priced responsibly.  NICE and NHS England have worked closely together over the last 2 years to achieve these objectives and were pleased to announce that positive NICE recommendations are increasing, two drugs are now exiting the fund into baseline commissioning and only 18% of drugs in the CDF have been negatively reviewed.  In addition NHS England has not overspent the allocated CDF budget and will therefore not need to invoke the overspend arrangement.

The new CDF model is based on a managed access agreement which involves three elements; evidence generation via a data collection phase, a commercial agreement around the price ie. the Commercial Access Agreement (CAA) and an agreement with the manufacturer to be subject to the expenditure control mechanism (ECM). Once these are agreed, the CDF ensures managed access to drugs with uncertainty that would otherwise have been “not recommended” by NICE, at a lower cost while data are collected to reduce uncertainty.  When drugs are re-appraised by NICE the final price is a new one based on the new ICER and not the CAA price.  As confirmed by Andrew Dillon, the whole point of the new CDF model is to establish the real value of new drugs.

A key message from NHS England and NICE to manufacturers is to engage early to ensure the best outcomes from the CDF.

With the success of the new CDF, Andrew Dillon’s parting question to the audience was whether  NICE should consider extending this kind of policy to other therapy areas?  Interesting times ahead!

OPEN Access Consulting is a market access consultancy and part of the OPEN Health Group. For more information on how we can help you engage early, please contact Dorinda Hickey, CEO, OPEN Access Consulting at