• More controversy for Cancer Drugs Fund

    January 2015

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Pharmaceutical companies are reportedly crying foul over an ‘outrageous’ announcement, expected from NHS England next week, that a number of cancer drugs – currently funded by the Cancer Drugs Fund (CDF) – are to be dropped because their cost outweighs the clinical benefit to patients.

As is often the case, these simple headlines belie a more complex narrative. On the one hand, oncology companies have been the beneficiaries of central funding for the last four years, notwithstanding the fact that NICE has previously ruled many of these drugs to be of insufficient value to warrant routine funding. Some would argue that they shouldn’t have been funded by the public purse in the first place.

Commentators argue – rightly, in my view – that the CDF was a political fudge from the outset and that its very existence undermines the role of NICE. But it is equally true that the current NICE appraisal processes do not serve particular medicines well. This is especially true for drugs for rare diseases, including some of the rarer forms of cancer. We urgently need an evaluation process (or processes) that is ‘fit for purpose’ and we need a long-term sustainable solution to how all medicines – not just cancer medicines – are priced and paid for across the UK.

Telling life sciences companies to cut their prices may be part of the solution, but is too simplistic (and easy) a response. Commercial companies should be allowed to make a return on their R & D investment, in the same way that we allow supermarkets to make a profit from bread and utility companies to make a profit on water, two other essentials for a healthy life.

But changing the CDF evaluation criteria (or goalposts?) part-way through its current term isn’t the answer. And neither is a sudden announcement that the CDF is no longer affordable – presumably because it has been so successful in extending access to new medicines – without having a coherent plan on how to replace it.

Because rest assured, the CDF will have to be replaced by something. As a minimum, there need to be suitable transition arrangements for patients who are currently being treated – many successfully – with the very same medicines that are about to be blacklisted.

Value-based pricing has been batted into the long grass. Its lite version – value-based assessment – has also been abandoned. The CDF is now being remodelled. Bashing life sciences companies isn’t the answer. But neither is cooking up policy behind part-open doors. All stakeholders need to be actively involved in deciding what comes next – including patients, professionals and life science companies. Because this time we need to get it right.

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