The U.K. has a workaround for expensive cancer drugs that its cost-effectiveness gatekeepers don't approve: a special fund to pay for those therapies, provided doctors jump through the hoops required to gain access.
That Cancer Drugs Fund just got a big injection of cash: £160 million, or about $265 million. The new money increases the annual spending power of that fund to £280 million from £200 million.
Plus, the fund has added a couple of drugs and indications to its list of sanctioned treatments: Xtandi (enzalutamide), Medivation's ($MDVN) prostate cancer therapy; and Revlimid (lenalidomide) from Celgene ($CELG), for patients with myelodysplastic syndrome. Both were rejected by NICE earlier this year. (Roche's ($RHHBY) Kadcyla, rejected earlier this month, is already among the chosen.)
For drugmakers (and U.K. patients with dedicated doctors), that's the good news. The bad, for the companies at least? The additional funding comes with strings attached.
For one thing, the National Health Service says it will review the drugs on its approved list, at the request of the fund's chairman, Peter Clark, an oncologist. "To ensure patients continue to have access to the best innovative treatments now and in the future, we must re-evaluate some of the drugs on the list," Clark wrote to the NHS (as quoted by The Guardian). "This is absolutely the right thing to do for patients."
But the broader effect of that list-review move is this: That increase in annual spending follows the fund's exceeding its budget limits, the BBC notes. So, government officials say, the fund needs more bargaining chips. That drug review is designed to offer just that--power to twist drugmakers' arms to reduce prices. Or, as Health Secretary Jeremy Hunt said, to ensure "this extensive additional funding is spent in the best way for patients."
|NHS chairman Simon Stevens|
This doesn't mean that the CDF will suddenly be capping prices or even forcing drugmakers to make cuts. The aim is to work somewhere between the NICE cost-effectiveness threshold and the much higher prices companies want to charge.
"Within this extra funding we want to ensure the drugs provide maximum benefits to patients and that the CDF incentivises responsible pricing by drug companies," NHS chairman Simon Stevens said (as quoted by The Guardian). "We want to create a sustainable Cancer Drugs Fund that will ensure patients don't miss out on innovative treatments that are on the horizon."