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MPs slam government for its poor management of Cancer Drugs Fund

Failure to assess value of Fund for patients and taxpayers ‘unacceptable’, says report

Caroline White

Friday, 05 February 2016

An influential panel of MPs has taken the government to task for its poor management of the Cancer Drugs Fund, including its failure to properly assess the value of the Fund to patients and taxpayers.

In a report published today, the parliamentary Public Accounts Committee says that while the Fund has enabled some 80,000 people to receive drugs, "the Department of Health and NHS England do not have the data needed to assess the impact of the Fund on patient outcomes, such as extending patients’ lives, or to demonstrate whether this is a good use of taxpayers’ money.”

This is "unacceptable,” it says.

The government set up the Fund in 2010 to boost access to cancer drugs that otherwise would not be routinely available on the NHS, because they have not been appraised by the National Institute for Health and Care Excellence (NICE), or don’t meet NICE’s clinical and/or cost effectiveness thresholds.

The Fund was initially managed for the Department of Health by the then 10 strategic health authorities, and expected to run until March 2014, with a total budget of £650 million. In 2013, the government extended the Fund until March 2016 and handed over its management to NHS England.

But the Fund has substantially run over its intended budget, and now has a total lifetime budget of £1.27 billion.

The report questions whether the Department of Health and NHS England are using their buying power effectively to pay a fair price for cancer drugs, and calls for clarity over the extent to which regional variations have been reduced "so that people across the country have equal access to the Fund."

"NHS England overspent the Fund’s £480 million budget for the two years 2013–14 and 2014–15 by £167 million. The cost of the Fund grew from £175 million in 2012–13 to £416 million in 2014–15, an increase of 138% in two years, but NHS England did not start to take action to control the cost until November 2014,” says the report.

There is general agreement that the Fund is not sustainable in its current form, and NHS England and the National Institute for Health and Care Excellence (NICE) are currently consulting on proposals to reform the Fund from April 2016.

"Clear objectives" should be put in place for what the reformed Fund aims to achieve, says the report.

And it urges NHS England to "be prepared to take tough decisions to ensure that the Fund does not overspend" and for the Department to "set out how it ensures that it pays a fair price for drugs and that the limit in the Pharmaceutical Price Regulation Scheme provides value for money for the taxpayer."

The Report calls on NHS England to report back to the Committee by June 2016 "on what the available data indicate about the impact of the Fund on patient outcomes.”

Committee chair, Meg Hillier said: "The Cancer Drugs Fund has enabled thousands of people to receive drugs not normally available to them through the NHS. While this is welcome it’s also clear the Fund requires significant and urgent reform if it is to be sustainable.”

She added: “A vital step in addressing the financial challenges must be to properly evaluate the health benefits of drugs provided through the Fund. If cancer patients seeking its support are to get the best possible treatment then there must be confidence that public money is being spent on the right medication, and at a fair price.”

An NHS England spokesperson said: "This report comes just a day after new independent figures showing the NHS' great success in improving cancer care and survival rates for patients across England.

"While we welcome the Committee's support for a redesigned cancer drugs fund, we hope their explicit call for cuts to cancer drugs prices charged to the CDF will be borne in mind as complex decisions on its future are taken in the next few months."

How would qualify the communication between primary and secondary care services? (See OnMedica News 20/04)

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