RS4 The Interim Cancer Drugs Fund - How To Not Spend £50 Million

Abstract

The Cancer Drugs Fund (CDF) was established in April 2011 by the UK government, with a pledge of £200 million additional funding for each of the next 3 years to increase patient access to high cost oncology drugs in England. As an interim measure, £50 million was distributed between the 10 strategic health authorities (SHAs) in England to cover the 6 months from October 2010 to March 2011. This research aims to identify how the interim CDF (ICDF) was spent, and to discuss how this could impact utilization of the CDF. Data regarding the total funding allocated to each SHA from the ICDF and how much of this money had been spent by March 31, 2011 were obtained from SHA websites. Missing data were accessed through freedom of information requests. Overall, there were over 2700 applications to the fund, with an average approval rate of 91%. Over the 6 month period covered by the ICDF, approximately £21 million was spent across the 10 SHAs in England; this constituted 42% of the £50 million allocated. There was significant variation in the amount spent by each SHA; the highest under-spend was in the South West, where 75% of funds remained unallocated. Several SHAs reported the forecasted costs for continuing treatment beyond March 2011; these costs were incurred in the 2011/12 financial year and therefore were not covered by the ICDF. Remaining budget is expected to be reclaimed by the Department of Health. It is clear that there was a significant under-spend of the ICDF by all SHAs. It is concerning that many funding applications were rejected, despite the fact that almost half of the funds remained unallocated. Steps need to be taken to ensure more effective use of the CDF and to minimise the risk of regional variations in drug access.