Cancer Drugs Fund 2.0: A Missed Opportunity?
The UK National Health service (NHS), like most other developed health care systems, has struggled with how to address the financial challenge created by the steady stream of increasingly expensive cancer treatments receiving regulatory approval. In the first decade of this century, the UK National Institute for Health and Care Excellence (NICE) Technology Appraisal process was used to identify those that were likely to represent good value at the manufacturer’s asking price, to negotiate price discounts where possible, and to explain withholding of funding when negotiations failed. During the 2010 election campaign, the future Prime Minister, David Cameron, promised to create a Cancer Drugs Fund (CDF) to pay for those drugs for which NICE gave a negative recommendation. Once in power, his government described the CDF as an interim arrangement until value-based pricing (VBP) was introduced, towards the end of their first parliament. Whilst initially underspent, in the last...
KeywordsNational Health Service Cancer Drug Consultation Document Technology Appraisal Appraisal Committee
This work has no direct funding. Christopher McCabe is funded from the Capital Health Research Chair Endowment at the University of Alberta; Mike Paulden is funded by the Genome Canada and CIHR through the PACEOMICS research programme. (www.paceomics.org)
- 1.National Audit Office. Investigation into the Cancer Drugs Fund. 2015.Google Scholar
- 2.Dillon, A. NICE calls for a new approach to managing the entry of drugs into the NHS. Press Release.Google Scholar
- 3.NHS England, N. Consultation on proposals for a new cancer drugs fund (CDF) operating model from April 2016. 2015.Google Scholar
- 5.Pharmaceutical Management Agency. Your guide to PHARMAC: setting and managing the combined pharmaceutical budget (CPB). [Fact Sheet 8] p. 1–2. https://www.pharmac.govt.nz/assets/factsheet-08-combined-pharmaceutical-budget.pdf Accessed 18 March 2016.
- 8.Unknown. New 50 million pound cancer fund already intellectually bankrupt. Lancet (London, England) 2010;376:389.Google Scholar
- 10.Prassad, V. Preventing cancer is biologically challenging: Rebuttal to Heidi Williams and colleagues: why use of surrogates and patent incentives won’t improve early cancer or chemoprevention drug development. Vinnay Prassad Blog. 2016.Google Scholar
- 11.Fojo T, Mailankody S, Lo A. Unintended consequences of expensive cancer therapeutics—the pursuit of marginal indications and a me-too mentality that stifles innovation and creativity: the John Conley lecture. JAMA Otolaryngol Head Neck Surg 2014;1225–1236. doi: 10.1001/jamaoto.2014.1570.
- 14.NICE. Consultation paper: value based assessment of health technologies. 2016.Google Scholar
- 15.Claxton K. et al. Methods for the estimation of the National Institute for Health and Care Excellence cost-effectiveness threshold. Health Technol Assess (Winchester, England) 2015;19:1–503, v–vi.Google Scholar
- 16.NICE. Guide to the methods of technology appraisal 2013. NICE London 2013. https://www.nice.org.uk/article/pmg9/resources/non-guidance-guide-to-the-methods-of-technology-appraisal-2013-pdf. Accessed 18 March 2016.