Presentation (CTI)

OBJECTIVES: The Cancer Drugs Fund (CDF), operated by NHS England, provides early access to promising cancer therapies through managed access agreements (MAAs) while additional evidence is generated to address clinical uncertainty, and also provides interim funding for newly recommended cancer medicines. This study aims to evaluate the trends and drivers of CDF MAA use in NSCLC and its impact on reimbursement outcomes.
METHODS: NICE technology appraisals (TAs) in NSCLC published from 1.6.2016-1.6.2026 were identified. Technologies that previously entered or were currently recommended for use in the CDF were analysed. Data extracted included the rationale for CDF entry, time from publication of the initial technology appraisals (TA) to publication of the final guidance post-CDF, clinical evidence, and final recommendation.
RESULTS: Over the last decade, 16/48 (33.3%) NICE TAs in NSCLC resulted in recommendation for use within the CDF via a MAA, including 3 currently in the CDF. Common drivers for recommendation to the CDF were immature survival data and uncertainties regarding utility/disutility estimates and stopping rules. Clinical evidence submitted in the initial TA was from head-to-head (n=10), single arm (n=4), and placebo-controlled trials (n=2). Only 2/16 included a managed access proposal as part of the initial TA submission. The average duration from initial TA publication to final recommendation post-CDF was 35.8 months (12.7-77.0 months). Following re-appraisal at the end of the managed access period, all technologies received a positive NICE recommendation.
CONCLUSIONS: The CDF has played a substantial role in facilitating early access to innovative cancer therapies in England, as seen in NSCLC where one-third of completed TAs entered the fund. Notably, all technologies reassessed following managed access subsequently received positive NICE recommendations, underscoring the CDF’s value in reducing decision uncertainty through evidence generation while supporting timely patient access and successful reimbursement outcomes.