PCN279 - A REVIEW OF RECOMMENDATIONS FOR INCLUSION AND DATA COLLECTION WITHIN THE CDF FRAMEWORK

Abstract

To explore the process and criteria used for consideration of treatments under the Cancer Drugs Fund (CDF) framework, and to describe the extent of evidence collection while in the Fund. A review of the NICE technology appraisals of all drugs included in the CDF (10.05.2018) was conducted. To compare with decisions in Scotland, the Scottish Medicines Consortium (SMC) determinations were also reviewed. Details were available on 17 indications for 12 drugs. Where reported, inclusion in the CDF was proposed in company submissions (n=10) or by the Committee (n=3). Drugs were indicated for adults with nine different types of cancer. Ten indications were for advanced disease and 13 for second or further-line therapy. Twelve cases met the end-of-life criteria. The major sources of uncertainty resulting in inclusion in the CDF related to: overall survival (n=11), information on comparator (n=7) and treatment duration (n=5). The planned data collection ranged from five to 42 months (median 21 months). All cases collected data through NHS systems and 15 through ongoing studies. Sufficient data on ICERs were available for 14 cases. The median ICER in the company’s base case analyses was £43,227 and the Committee’s preferred ICER was higher by a median of £11,602. All available ERG ICERs were higher than the company’s. The SMC accepted 13 indications, rejected one and no decision was available for three cases. The included cases were mostly in difficult to treat patients: second-line, advanced cancer, meeting end-of-life criteria. The most common source of uncertainty was insufficient overall survival information. Data collection was often planned for a period beyond the assumed usual two years and in most cases it involved continuation of ongoing studies. The SMC rejected only one of these indications despite potential gaps in evidence, resulting in similar treatment availability.