NHS England has announced a surprise £60m boost to the cancer drugs fund, bringing it up to £340m for 2015-16, even as it slashes the number of drugs available.
Under the changes, eight drugs will cease to be available through the fund under any circumstances, while a further eight have had the range of indications - conditions for which they can be prescribed - reduced.
Four new treatments have been added to the list, including Panitumumab, a treatment for bowel cancer.
The changes were widely expected after NHS England began evaluating the cost effectiveness of medicines available through the fund last autumn in a bid to bring down its spiralling cost.
However, sources in the pharmaceutical industry told HSJ the announcement of extra money for the fund in 2015-16 had been a surprise. The fund for the next financial year had originally been set at £280m, which was already a 70 per cent increase since it was set up in 2010. The further increase is likely to prove controversial as it will reduce the funding available to spend on other conditions and types of care.
HSJ understands the money will come from the £14.6bn already allocated to specialised commissioning for 2015-16 and has been set following modelling of what is likely to be spent on the new list of drugs available through the fund.
NHS England said it was also forecasting £80m of savings on the fund through negotiated price reductions for certain drugs and more effective treatments.
For example, Roche has reduced the price of its controversial breast cancer drug Kadcyla, which previously cost an average £90,000 per patient and has been found to extend life by six months compared to routinely funded treatments.
However, a spokesman confirmed they were considering whether to appeal NHS England’s decision to remove Avastin from the fund for treatment of two types of cancer.
HSJ understands Sanofi is also considering appealing the complete removal of its drug Jevtana, for the treatment of hormone-resistant prostate cancer.
Under the changes patients currently receiving a drug treatment through the fund will continue to receive that treatment, even if the drug is no longer in the fund.
Responding to the new list of available drugs, industry and patient charities were united in calling for urgent reform of the National Institute for Health and Care Excellence’s system for assessing the cost effectiveness of new drugs.
Stephen Whitehead, chief executive of the Association of the British Pharmaceutical Industry, said: “Whilst we are pleased that treatment for existing patients will be protected as a result of this decision and that some new medicines will be included in the [fund], it does not detract from our longstanding belief that the [fund] and this re-evaluation process was fundamentally flawed.
“The solution to this issue remains the urgent reform of NICE which will ensure that the right patients get the right medicines at the right time whatever their condition.”
Peter Clark, chair of the cancer drugs fund and a practising 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.”