The interim Cancer Drugs Fund – how will it work and will it improve access for patients? - Cancer Research UK

The new interim Cancer Drug Fund should help patients get access to drugs

This morning, the Department of Health announced the details of a new ‘interim’ Cancer Drugs Fund.

This Fund is £50 million of ‘new money’ (or ‘additional in-year funding’, in Government speak) to be spent on drugs for cancer patients, to fill the gap between now and April next year when the official Cancer Drugs Fund will come into effect.

This money is intended to make sure that when a doctor wants to prescribe a specific drug for their patient, the people holding the purse strings at the local level in the NHS will have extra money to pay for it, regardless of whether the drug has been approved or not by NICE.

The Cancer Drugs Fund is the brainchild of new Secretary of State for Health Andrew Lansley, and was born out of the Conservative manifesto – and reiterated in both the Coalition Programme for Government and the recent Health White Paper Equity and Excellence: Liberating the NHS.

Originally this Fund was due to start from April next year and run until 2014 – when Government says it will introduce a brand new system of ‘value based’ drug pricing. This ‘interim’ Fund announced today is additional money to tide the country over until the ‘official’ Fund begins in April.

This new money is great news for people currently being treated for cancer. A recent Government report showed that fewer new cancer drugs were prescribed in the UK compared to other countries in Europe – possibly because of a lack of available funding.

But although the launch of the fund is good news, we still have a few questions about how it work in practice.

How will the fund actually work?

England is divided up into ten regional ‘Strategic Health Authorities’ or SHAs, which are responsible for local planning, monitoring quality and managing the capacity of local health services.

Earlier this year, Sir Bruce Keogh, the NHS’s medical director, wrote to the SHAs to outline how this funding should be applied.

In summary, the total £50 million is to be broken down into smaller chunks of money and distributed to the 10 SHAs, with the amount each receives depending on the size of its population. In practice, this will range from around £7.5 million for the London and North West SHAs to just under £3 million for the North East SHA.

All SHAs should by now have ‘clinically-led panels’, made up of doctors and commissioners (who are responsible for buying treatment and care for the NHS), to receive requests from doctors on a case by case basis for their share of the £50 million.

However, the guidance also states that “all other funding routes” should be exhausted before patients can qualify for these funds.

These include existing agreements by local health providers that drugs not yet approved by NICE are made routinely available in their area, or “exceptional case” prescribing. “Exceptional cases” are when doctors can ask for money on a case-by-case basis because they think their patient is clinically more likely to benefit from a drug than the general population.

Because of this, the Cancer Drugs Fund runs the risk that patients could be left waiting while doctors fill in completely unnecessary forms, purely to prove that they have ‘exhausted’ these options.

So, for this fund to work as it should, doctors will need to be provided with clear guidance about how to apply – and decisions need to be made quickly and appropriately.

We would also like to know what will happen if this money is used up before April 2011.

It will be very interesting to see how the interim fund is spent over the next six months. If all goes to plan, it should ensure that no patient is denied a cancer drug which might help them – which has got to be a good thing in anyone’s book.

Preparing for the ‘official’ Cancer Drugs Fund

The Government still hasn’t published details of the official Cancer Drugs Fund (as opposed to today’s ‘interim’ fund), which starts in April next year. At the moment we don’t know how this will be distributed, or even how much this will be (£200 million was originally allocated, but this is now being cited as an ‘aspirational’ figure).

The Department of Health is due to publish a consultation on all of this over the next month or so. We will be working closely with the other cancer charities to make sure that this provides three things.

Firstly, it needs to provide reassurance for cancer patients that the Fund will be well set up and managed. There also need to be safeguards in place to ensure that not only is sufficient funding allocated, but that there isn’t a danger of this getting inadvertently redirected into another of the health service’s many priorities. And finally there must be a clear, transparent, process for doctors which allows them to give their patients treatments they think will benefit them.

Hilary

Hilary Tovey is Cancer Research UK’s Policy Manager