Download Cancer Drugs Fund

Cancer Drugs Fund
Dr Andy Stainthorpe
ACS CDF for RH
CDF content
• Role and remit of the fund
• Recent developments
• The CDF and biosimilars
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Political input
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Context
• NHS spends approximately £1,300,000,000 annually on cancer
drugs within routine commissioning.
• CDF has provided an additional £200m each year
• CDF established in 2010 & will run until the end of March 2016.
• Provides access to drugs that NICE has or might recommend not be
used in the NHS on grounds of cost-effectiveness
• In a run up to the 2015 election NHS England recently pledged an
additional £160m over the next two years to strengthen the fund.
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Evolution
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Early chaos - under used resource
London hospitals and commissioners develop objective system
Growing list of approved medicines
Expanding use – becoming an overused resource
Need to rationalise and
RATION access
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CDF Impact
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Recent developments – example
Drug/indications lost
No
1
Medicine
Aflibercept
Indication
second line treatment of metastatic colorectal cancer
2
Bendamustine
rituximab refractory low grade lymphoma
3
4
5
6
7
Bevacizumab
 first line treatment of advanced colorectal cancer 1&2
 2nd line treatment of advanced epithelial ovarian, fallopian
tube or primary peritoneal cancer
 relapsed multiple myeloma
 relapsed Waldenstrom's Macroglobulinaemia where
8
9
Bosutinib
Cabazitaxel
treatment of blast crisis Chronic Myeloid Leukaemia
castrate-resistant Metastatic Prostate Cancer
10
Cetuximab
 second or third line treatment of metastatic colorectal
cancer
Bortezomib
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Relevance to biosimilars??
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CDF is a NICE bypass
NICE may not assess Biosimilars
Clinicians may not have mandate to prescribe Biosimilar
Biosimilar through CDF may be an option
Guidance from NICE is not always adhered to – clinicians have
freedom to prescribe what is best for their patients if
hospital/commissioners will reimburse it.
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Future - short to medium term
May 2015 - UK election
All committed to some form of CDF
May be greater or lesser pressure on the NHS
Continued growth in Health spending unaffordable
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Future – longer term
Continued growth in health spending unaffordable
Value-based assessment in NICE
Potential changes to NHS
Insurance based component
Co-pay options
wider range of risk shares
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Recommendations
• Consult early on Market Access approaches which might include
CDF /successor
• Consult earlier on Market Access
• Plan where the drug is going to fit into each countries market
• In rarer cancer indications look to ultra-orphan HST/ CDF
/successor/HTA
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Thanks
Questions
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