Intended for healthcare professionals

Feature Briefing

Which way now for the Cancer Drugs Fund?

BMJ 2014; 349 doi: (Published 09 September 2014) Cite this as: BMJ 2014;349:g5524
  1. Andrew Jack, deputy editor, analysis, Financial Times, London, UK
  1. andrew.jack{at}

The government has extended the Cancer Drugs Fund for a further two years and increased its budget. Andrew Jack explains how it works and why it is controversial

What is the Cancer Drugs Fund?

The Cancer Drugs Fund was created in 2010 by the coalition government to pay for new cancer drugs that the NHS would otherwise not have provided because the National Institute for Health and Care Excellence (NICE) considered they were not cost effective. A budget of £200m (€250m; $330m) a year was set for four years using money the government initially said had been saved by the NHS “through our pledge to stop the rise in employer National Insurance contributions from April 2011.”1

Oncologists can apply to the fund on a case by case basis, and they usually do this after a drug has been rejected by NICE. Committees of medical specialists decide whether to approve a drug for NHS use based on a 12 point scale for clinical effectiveness. Since it was created, the fund has approved about 43 drugs for 80 different indications,2 allowing an estimated 55 000 patients to receive treatment. Around 20 drugs (for 31 indications) have been refused.

Why was it set up?

NICE was rejecting a growing number of new cancer therapies because it considered them too expensive for their modest benefits (usually …

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