ISSUE

: The Cancer Drugs Fund (CDF), re-established in 2016, provides patients with earlier access to new cancer drugs and a mechanism for managed access for promising new treatments where significant clinical uncertainties exist. A key component of Managed Access Agreements (MAAs) is further data collection with the objective of addressing uncertainties identified throughout the NICE Technology Appraisal process.

With a ring-fenced budget, high-cost medicines and increasing political pressure to provide earlier access, it is yet to be determined how sustainable the continued growth of the CDF will be, and how effective data collection arrangements are in resolving uncertainty at the time of reappraisal.

OVERVIEW

: This panel will debate the pros and cons of the current CDF system and explore alternative approaches to how uncertainty can be handled throughout the HTA process.

Prof. Akehurst will begin the session by providing an overview of the revised CDF and corresponding MAAs including the relevant implications for future decision making. Case studies will be provided, drawing upon the findings of a detailed review of CDF recommendations made since the formulation of the revised system in June 2016. The case studies will comment on the degree with which the uncertainties identified during appraisal process correspond to data collection targeted by the CDF. Prof. Akehurst will then pose key questions for the panellists to debate:

• Does the current CDF system provide an effective approach to managing uncertainties?
• What lessons can be drawn from how other countries implement MAAs?
• Are there alternative processes or mechanisms that could be developed to help improve managed access in England and more widely?

These questions will enable an informed, interactive 15-minute discussion with the audience at the end of the issue panel, relating to practical steps that can be taken to improve MAAs in the future.