Sixty seconds on . . . the Cancer Drugs Fund

BMJ 2016; 352 doi: (Published 09 February 2016) Cite this as: BMJ 2016;352:i791
  1. Nigel Hawkes
  1. 1London

What has England’s Cancer Drugs Fund cost?

Since its creation in 2010, £1.27bn. It has treated 80 000 people, roughly, so the average has been £16 000 per patient.

Money well spent?

Impossible to say. Nobody has followed up the patients assiduously enough to put a value on the benefits.

That sounds negligent to me

You may think so. The Public Accounts Committee found that the Department of Health and NHS England failed to control costs or to measure benefits.1 That’s unacceptable, the MPs said.

Any positives?

By 2013 use of new cancer drugs almost matched that of 13 other similar countries, instead of being less than half, as it was in 2009.

But if we don’t know they do much good . . .

Then we’re all united in burning money on expensive drugs that rational analysis says aren’t cost effective.

OK, but if today’s expensive branded drugs are rejected, where are tomorrow’s cheap generics going to come from?

There probably is a case for reimbursing some expensive drugs in return for long term benefits when their patents run out, though it’s not clear that this will ever apply to new cancer drugs that are biologicals and may never be all that cheap.

Is that why the fund was launched?

No. It was to stem complaints from patients’ groups that the use of new drugs was low in the United Kingdom and that its cancer outcomes were poor. The motivation was political, which doesn’t make it wrong. Angry voices were silenced and anxious families reassured. So it worked, politically.

But if that meant that others were denied, wasn’t it a swindle?

Allocation of resources is never wholly rational. It may be reprehensible to pander to those who have the loudest voices, but that’s usually the safest bet.

What now?

The fund is being reformed, with clear entry and exit criteria. But it’s unlikely to provide a permanent bridge between what drug companies want to charge and what the NHS can sensibly pay.


Cite this as: BMJ 2016;352:i791


View Abstract

Log in

Log in through your institution


* For online subscription