England's Cancer Drugs Fund (CDF) is again under attack. The specialty fund has been getting it from both sides lately, as both drugmakers and cancer patients are upset over its deletion of coverage for a couple of dozen drugs, and officials and researchers say it is not living up to its promise.
This time former health minister Paul Burstow tells PMLive in an exclusive interview that the fund has failed to do what it was set out to do and probably shouldn't be just for cancer anyway. Why isn't the fund used for new promising medical devices or for meds for other diseases? The criticism comes as the fund has been trimmed down to save money, although PMLive says there are reports that some drugmakers have gotten officials to rethink some decisions.
The Cancer Drugs Fund was supposed to be collecting data that price watchdog NICE could use to decide if meds were worth the National Health System paying for them, Burstow tells PMLive. But it hasn't, leaving Burstow to question whether patients or the government has gotten much benefit from the £1 billion in additional payments the fund has made since it was created in 2010. "Really, we've gained no insight or learning from the dozens of drugs being funded within the scheme," Burstow tells the publication.
He also doesn't understand why the fund pays all of the costs of these treatments instead of seeking discounts or patient access schemes as cost watchdog NICE does when approving other meds. And limiting the fund to just cancer, or just drugs, has been a mistake, he believes. "I would personally propose a 'drugs and devices fund' that was broader in its scope than just for cancer--it has to be an aid to bringing drugs to access at an earlier stage," said Burstow.
Burstow is not alone in believing the fund is not doing all it could but each player has a different view of where the problems lay. CDF critics and drug companies point out that if NICE were less restrictive in approvals of expensive, late-stage cancer treatments, the fund wouldn't be needed. A recent study also indicates that England is falling behind some European countries in offering the newest and most advanced cancer treatments. But other research suggests the costs of the fund are keeping patients from getting other important medical benefits.
The debate heated up in January as the government decided to jettison some drugs from the list, at least for certain conditions, because the fund is running way over budget. The fund is expected to exceed its £200 million annual budget ($422 million) by £100 million by the end of the fiscal year. The government promised an additional £160 million to fund the difference but, in exchange, granted the fund power to trim the list. While PMLive says a final list is still to be laid out, the CDF in January said the fund would now have 62 approved indications, rather than its original 84. The cuts are estimated to save £80 million ($121.3 million) a year.
A firestorm arose in when companies such as Novartis ($NVS), Sanofi ($SNY) and Eisai were informed ahead of the posting that some of their treatments would be eliminated from the fund's coverage. PMLive says that the backlash from the announcements appears to have changed the mind of decision makers, at least for some indications.
It reports that Novartis' Afinitor may be approved for two of three indications, and that Eisai's breast cancer treatment Halaven, which was axed, may also be allowed after the company appealed the decision. Eli Lilly ($LLY) told PMLive that it believes its lung cancer treatment Alimta may be returned for treating some patients with non-squamous non-small cell lung cancer.
- read the PMLive story
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