Bridging the Uncertainty: Cancer Drugs Fund Entry and Exit Outcomes Over Three Years
Author(s)
Humoon Afsardeir, MSc.
Newmarket Strategy, London, United Kingdom.
Newmarket Strategy, London, United Kingdom.
OBJECTIVES: The Cancer Drugs Fund (CDF) aims to provide NHS patients faster access to promising cancer medicines while additional data resolves clinical or cost-effectiveness uncertainties. This analysis evaluated NICE re-appraisal outcomes for CDF-approved therapies since February 2022, to assess routine commissioning success rates and how additional evidence influenced committee decisions.
METHODS: All CDF-approved therapies re-appraised by NICE for routine commissioning between February 2022 and March 2025 were reviewed. Publicly available NICE documents were analysed to determine positive recommendation rates at CDF exit, median time from CDF entry to exit, changes in approved indications, differences in submitted incremental life years (LYs) and quality-adjusted life years (QALYs), and common remaining uncertainties after managed access.
RESULTS: 24 CDF-approved drugs were re-appraised during the period. Of these, 23 (95.8%) received a positive NICE recommendation and one was not recommended. Most re-appraisals (69.6%) had no indication change; five (21.7%) had narrower indications, and one (4.3%) had a broader indication. Median time from CDF entry to routine commissioning was 43.6 months, often exceeding planned data collection durations partly due to reappraisal timelines. All re-appraisals at least partially addressed initial uncertainties, with five (20.8%) having no substantial uncertainties remaining. Submitted incremental LYs and QALYs were broadly similar at CDF entry and exit, suggesting predictions were generally accurate despite initial uncertainty. Common remaining uncertainties included long-term survival extrapolation, lack of robust comparative evidence against scoped comparators, model structure assumptions, and trial generalisability to NHS clinical practice.
CONCLUSIONS: Currently, a high proportion of CDF exits have received a positive recommendation. Despite a higher level of uncertainty at CDF entry, companies reported similar LY and QALY gains at re-appraisal. This raises additional research questions on whether: (1) CDF entry should be recommended for a smaller proportion of therapies with the largest evidence uncertainties; and whether (2) the duration of managed access periods remain suitable.
METHODS: All CDF-approved therapies re-appraised by NICE for routine commissioning between February 2022 and March 2025 were reviewed. Publicly available NICE documents were analysed to determine positive recommendation rates at CDF exit, median time from CDF entry to exit, changes in approved indications, differences in submitted incremental life years (LYs) and quality-adjusted life years (QALYs), and common remaining uncertainties after managed access.
RESULTS: 24 CDF-approved drugs were re-appraised during the period. Of these, 23 (95.8%) received a positive NICE recommendation and one was not recommended. Most re-appraisals (69.6%) had no indication change; five (21.7%) had narrower indications, and one (4.3%) had a broader indication. Median time from CDF entry to routine commissioning was 43.6 months, often exceeding planned data collection durations partly due to reappraisal timelines. All re-appraisals at least partially addressed initial uncertainties, with five (20.8%) having no substantial uncertainties remaining. Submitted incremental LYs and QALYs were broadly similar at CDF entry and exit, suggesting predictions were generally accurate despite initial uncertainty. Common remaining uncertainties included long-term survival extrapolation, lack of robust comparative evidence against scoped comparators, model structure assumptions, and trial generalisability to NHS clinical practice.
CONCLUSIONS: Currently, a high proportion of CDF exits have received a positive recommendation. Despite a higher level of uncertainty at CDF entry, companies reported similar LY and QALY gains at re-appraisal. This raises additional research questions on whether: (1) CDF entry should be recommended for a smaller proportion of therapies with the largest evidence uncertainties; and whether (2) the duration of managed access periods remain suitable.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA58
Topic
Clinical Outcomes, Economic Evaluation, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
Oncology