Cancer Drugs Fund

This page is about the Cancer Drugs Fund. There is information about

What the Cancer Drugs Fund is
Explaining the fund
How to find out which drugs are available through the fund
Who can apply for drug funding?
How decisions are made

Changes in the list of funded drugs
Living in a different area from where you are having treatment
How long does it take to make the decision?
Coping if you can’t have a particular drug

The Cancer Drugs Fund is money the Government has set aside to pay for cancer drugs that haven’t been approved by the National Institute for Health and Clinical Excellence (NICE) and aren’t available within the NHS in England. This may be because the drugs haven’t been looked at yet or because NICE have said that they don’t work well enough or are not cost effective. The aim of the fund is to make it easier for people to get as much treatment as possible.

The Cancer Drugs Fund is for people who live in England. The governments of Scotland, Wales and Northern Ireland decide on how they spend money on health and so far haven’t decided to have a similar programme.

The Cancer Drugs Fund started at the beginning of April 2011. This fund is shared between the 10 Strategic Health Authorities (SHAs) in England. The fund is to continue until the end of March 2014. From 2014 the Government plan to introduce a new way of setting prices for cancer drugs which aims to make more drugs routinely available in the NHS.

The Government have said that the fund is worth £200 million per year. During the 3 years the Fund is in place, the Government will review how well it is working and may make changes.

The fund is shared out between the 10 Strategic Health Authorities (SHAs) in England. The way individual SHAs organise their Cancer Drugs Fund varies. Generally how they make decisions about funding drugs is very similar. But the list of drugs that they will consider funding varies between SHAs.

Within each SHA there is a panel of specialist cancer health care professionals who decide which drugs should be available through the fund. Most of the SHAs have made a list of drugs that they will pay for through the fund. You may hear this list called a priority list.

All Primary Care Trusts (PCTs) already have a process for providing funding for particular treatments in individual or exceptional circumstances and this is still in place. It depends on whether the treatment is available through this as to whether your doctor has to apply to the PCT first. If it the SHA has already decided that a treatment should be available for a particular group of people through the cancer drugs fund (CDF) they do not need to go through the PCT first. They can apply directly to the CDF. If no decision has been made by either the PCT or the CDF the doctor decides whether it is best to apply to the PCT first or go to the CDF.

The SHAs lists include information about which type of cancer the drug can be used for. A list may also include information about the stage of disease and what other treatments you must have already had, or should not have had. This means that although a drug may be funded for one type of cancer, at a particular stage, funding may not be available for the same cancer at a different stage or for another type of cancer.

You can find out more about the drugs that are covered from your particular SHA using the links below. The 10 SHAs are

If you are not sure which SHA you live in you can find information about them on the NHS Choices website.

Your cancer specialist applies for you to your local Strategic Health Authority. You can’t apply directly yourself. Your cancer specialist is in the best position to suggest treatment that is best for you and provide evidence to the panel about why they think you need the treatment.

Your cancer specialist makes the decision based on your type and stage of cancer, as well as any treatments you have had and your general health. They also talk to you about what you want.

You can read more about this on the pages about treatment types in the cancer types section. Choose your cancer type from the list and go to the treatment section and then choose the types of treatment page.

The basic process is similar but is not exactly the same in all of the SHAs. Your cancer specialist applies to the Cancer Drugs Fund panel for your particular SHA or area within the SHA. They must have already considered any other treatments already available for your type and stage of cancer. Your specialist may also need to have already applied to your PCT for exceptional funding, or special funding, for treatment that is not routinely available within the NHS within your primary care trust (PCT).

If the drug your specialist is applying for is on your SHAs list, your specialist thinks it is appropriate for you, and you want it, it is likely that you will be able to have the drug.

This is not always as easy a decision as it first appears. Many of the drugs that are on the lists are for people who have already had all the other treatments available. It is important to discuss all the pros and cons to having any of these treatments with your specialist. You can find information about individual cancer drugs and their side effects in the treatment section. Choose the cancer drug from the alphabetical dropdown list to get to the information. There is also information on the research page for your cancer type about new treatments and research that is ongoing.

If the drug your doctor wants you to have is not included in the SHAs list it depends on your SHA as to what happens next. In some areas if it is not on the list you won’t be able to have the drug and your doctor has to apply to your PCT for funding if they haven’t already done so. In other areas the SHA Cancer Drugs Fund panel makes a decision. If they decide not to pay for the drug they will give a full explanation about why they have made that decision.

They make a decision by looking at

The reasons why your specialist thinks you need it
Your stage of disease and general health
What other treatments are available
The evidence about how well the drug works and possible side effects
The cost of the drug

Each SHA should have a process for dealing with appeals against funding decisions.

The drugs that the SHA will fund may change during the year as new drugs become available or if NICE makes a decision making the drug routinely available within the NHS. From what we understand at the moment, the money available for the Cancer Drugs Fund for each SHA lasts for a year, or until the fund runs out, whichever comes first. This means that the doctors on the panel have to think about which drugs patients in their area are likely to need, as well as what they will cost. It is up to each SHA as to how often they review the list. We don’t yet know what will happen if the money for a particular area runs out before the end of the financial year.

Your specialist has to apply to the Strategic Health Authority that covers where you live and not the one where you are having treatment.

The SHA panels understand that it is important for decisions to be made as quickly as possible. The time this takes seems to vary, depending on your SHA. The Government have said that it must be within 31 days, but should be sooner. In some areas, if the drug you need is on the SHAs list your doctor may simply fill in a form and you will be able to have the drug within a few days. But the process is not the same for every area. Your specialist should be able to tell you how long it is likely to take in your area. Most of the SHAs have patient information on their websites about their process. You can use the links above to find it.

If you are unable to have the drug you want, you are likely to be very disappointed. It can be difficult to come to terms with. You may feel a range of emotions including anger. It can help to talk to your specialist about why funding was turned down.

It may also be worth speaking to your specialist about whether there are any other treatments you can have. There are often trials of new experimental treatments going on and you may be able to take part in one of them. Our clinical trials database has a list of trials both open and closed. Choose your cancer type from the dropdown list and choose ‘are still recruiting’ to find ones that are available. There is also information about different types of trials and about taking part in a trial.