Twenty-five cancer treatments will no longer be supported by the Cancer Drugs Fund, say NHS England.
This is despite the fund’s budget being grown from £200 million in 2013/14, to £280 million in 2014/15, and an estimated £340 million from April 2015.
Some drugs will be removed and others restricted – a move charities say could leave some without crucial treatments.
Cancer patients currently receiving the treatments will still be allowed to continue using them.
The restrictions come into place from 12 March and affect a whole range of treatments for breast, pancreatic and bowel cancer.
The most commonly used treatment that will be dropped is Avastin for advanced bowel cancer. The Rarer Cancers Foundation estimates the step will result in more than 7,700 patients losing out.
The CDF review will also create projected savings of approximately £80 million through a combination of negotiated price reductions and improved clinical effectiveness.
The Fund is projected to have grown to around £420 million next year, necessitating offsetting cuts in other aspects of cancer treatment such as radiotherapy, cancer diagnoses, and cancer surgery.
A national panel – comprising oncologists, pharmacists and patient representatives -independently reviewed the drug indications currently available through the CDF, plus new applications.
They carried out a detailed assessment of the evidence, looking at clinical benefit, survival and quality of life, the toxicity and safety of the treatment, the level of unmet need and the median cost per patient.
In cases where the high cost of a drug would lead to its exclusion from CDF, manufacturers were given an opportunity to reduce prices.
The result of the review is that 59 of the 84 most effective currently approved indications of drugs will rollover into the CDF next year, creating room for new drug indications that will be funded for the first time. These are Panitumumab, a treatment for bowel cancer; Ibrutinib, a treatment for Mantle cell lymphoma, a type of non-Hodgkin lymphoma; and Ibrutinib for use in chronic lymphocytic leukaemia (CLL).
Following these changes, four patient protections have been put in place:
– Any patient currently receiving a drug through the CDF will continue to receive it, regardless of whether it remains in the CDF.
– Drugs which are the only therapy for the cancer in question will remain available through the CDF.
– If the CDF panel removes a drug for a particular indication, some patients may instead be able to receive it in another line of therapy or receive an alternative CDF approved drug.
– Clinicians can apply for their patient to receive a drug not available through the CDF on an exceptional basis.
Professor Peter Clark, Chair of the Cancer Drugs Fund (CDF) and an oncologist, said: “We have been through a robust, evidence-based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound.
“There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those. There were others that offered some benefit but were costly and I am pleased that a number of pharmaceutical firms worked with us to make prices more affordable, saving millions of pounds that can now be reinvested in other treatments.
“These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”