[Ip-health] pharmaphorum: Prime Minister intervenes on future of Cancer Drugs Fund

Thiru Balasubramaniam thiru at keionline.org
Tue Nov 10 05:38:18 PST 2015


Prime Minister intervenes on future of Cancer Drugs Fund


Andrew McConaghie

10th November 2015


StrategyRegulatory / complianceFinancialMarket accessOncologyUK
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The future of the England's Cancer Drugs Fund (CDF) is to be decided by the
Prime Minister David Cameron, pharmaphorum has learnt.

Sources close to the decision-making have confirmed to pharmaphorum that
the fate of the CDF, now costing £340 million a year, will be decided by
Downing Street, and not by the Department of Health or NHS England.

Mr Cameron is understood to have demanded final say on the CDF because
cancer treatment – and the rows over access to expensive new drugs – is
such a highly charged issue with voters.

Number 10's intervention comes against a background of an escalating row
between health secretary Jeremy Hunt and doctors and other healthcare

Hunt's confrontational handling of negotiations with NHS leaders on
introducing seven-day working in the NHS and a new junior doctors' contract
has generated huge animosity, with junior doctors in England now
considering strike action.

David Cameron has now stepped in to ensure no further damaging rows are
inflicted on his government.

One reason for this is clear: Cameron played a key role in setting up the
Fund in 2010, which had been a Conservative manifesto pledge in the general
election in May of that year. Conceived as a temporary – and very political
– solution to bypassing the frequent and hugely unpopular 'no' decisions on
cancer drugs from cost effectiveness watchdog NICE, the CDF is still in
operation, and looks likely to remain, in one guise or another.

Mr Cameron's intervention has disrupted plans for a new, revamped CDF to be
launched in April 2016, and has thrown a spanner in the works of an ongoing
review of the entire medicines access system.

NHS England was forced to confront the CDF's overspend in late 2014, after
the list of drugs given funding continued to grow, and the Fund's overspend
ballooned, set against a growing NHS funding crisis.

This has led to two rounds of 'de-listings' of drugs from the Fund,
undermining the political raison d'etre of the CDF.

Budget holder NHS England announced a proposal for a 'sustainable' system
in July, turning the CDF into a managed access fund linked to NICE.

However the public consultation on the plans has never emerged, with Number
10 intervening before this could happen.

News of the delay has reached stakeholders, including charities and pharma
companies, but the reason behind it has not been made public until now.
Pharma industry association the ABPI last week said it was disappointed
with the hold up, saying the future of the CDF was of "utmost importance to
both patients and the industry".

Alison Clough, acting chief executive of the ABPI, said: "The backlog of
medicines which are inaccessible to patients will continue to build unless
the consultation is urgently progressed and new arrangements are in place
from April 2016. The situation also causes huge uncertainty for the UK
research environment. We would urge the government to end this delay and
publish its consultation on proposals for the CDF."

The CDF's chairman Professor Peter Clark has made his feelings clear on the
future of the Fund, calling on the government to introduce a more flexible
system, allowing greater risk sharing between pharma and the NHS on price
and the clinical benefits of promising but unproven drugs.

Speaking last night as a guest of honour at the annual dinner of
small-medium pharma trade organisation the Ethical Medicines Industry Group
(EMIG), Prof Clark said the 'rigidity' of the UK's pricing system needed to
end, and did no favours to the NHS, industry or patients.

Prof Clark said a sustainable solution was needed, as new cancer drugs
covering at least 40 indications were expected to be launched in the UK
over the next few years.

The Prime Minister's intervention comes as another government-sponsored
initiative, the Accelerated Access Review (AAR) works to find an
'end-to-end' solution for new medicines, medical devices and digital
innovation to be adopted by the NHS.

The AAR is also expected to produce its final recommendations in April
2016; some had inferred that the delay to the CDF consultation was caused
by a determination to co-ordinate these different initiatives in a
fragmented NHS.

"If only things were that joined up," the source wryly commented to

Leslie Galloway, chairman of EMIG wants to see the wholescale reform of the
UK pricing and market access system. This would include the CDF being
absorbed into a New Medicines Fund, which would help speed uptake of
medicines for all conditions, not just cancer.

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