The Cancer Drugs Fund (CDF), founded in 2011, has benefited a large number of cancer patients. However, the lack of clear criteria determining how and when drugs should exit the fund placed it under unsustainable financial pressure. In 2016, the CDF was revised to provide a more sustainable approach to fund promising new drugs and collect additional clinical data. Some treatments recommended for funding via the new CDF have now been re-assessed for routine commissioning. This research aims to highlight differences between the old and new CDF, identify the key reasons for CDF funding and assess outcomes of products that have been re-assessed for routine commissioning. Secondary analysis of NICE appraisal documents and primary research with NICE/CDF representatives. The revised CDF provides NICE the option to recommend treatments for use within the CDF; previously, it could only recommend ‘yes’, ‘no’ or ‘only in research’. This new option is used when NICE considers there to be plausible potential for drugs to satisfy criteria for routine commissioning, but where significant clinical uncertainty remains. Of the 34 drugs currently receiving CDF funding, immature overall survival and progression-free survival data are the main reasons for clinical uncertainty. Analysis of eight drugs that have entered routine commissioning found that providing additional data after two years, modification of the Patient Access Scheme or updated cost-effectiveness calculations support positive NICE recommendations for routine commissioning. The advantage of the new CDF is that promising new cancer drugs can be granted provisional status, allowing immediate access to patients. During the two-year funding period, manufacturers must appropriately collect and model clinical data to address uncertainty and ensure cost-effectiveness, through discounting if required. Early dialogue with NICE and NHS England will ensure appropriate trial design so that NICE is convinced that clinical uncertainty can be mitigated by further data collection.