OBJECTIVES: The aim of this study was to investigate the outcomes of products that were recommended by the National Institute for Health and Care Excellence (NICE) for use within the Cancer Drugs Fund (CDF), and to provide pharmaceutical companies with insight on the success rate of NICE reappraisal after CDF exit.

METHODS: A retrospective data analysis from the NICE website was conducted. 53 CDF recommendations and 27 CDF reappraisals were identified between 1 October 2016 and 14 April 2023. The status of each CDF recommendation was investigated on the website of NICE guidance, and each reappraisal was linked to the original appraisal to investigate the outcome of the CDF exit.

RESULTS: Between 1 October 2016 and 14 April 2023, 53 products were recommended for use within the CDF, of which 25 (47%) are still in the CDF, 27 (52%) have been reviewed, and one (1%) has been withdrawn because the product no longer has a marketing authorization. Of the 27 products that have been reappraised after exiting the CDF, 9 (33%) were recommended for routine commissioning, 15 (56%) were recommended with restrictions for routine commissioning, two (7%) were not recommended, and one (4%) was terminated because the company did not provide an evidence submission.

CONCLUSIONS: Following CDF exit, 89% reappraisals received a positive recommendation for routine use in the NHS, indicating that additional data collection and commercial re-negotiations reduced uncertainty enough for NICE to make a positive recommendation. If there are data uncertainties in the appraisal process, engaging early with NICE can provide an opportunity to allow medicines to be made accessible despite these uncertainties. The CDF provides an access route and allows the generation of data to address these data uncertainties, ensuring optimized access for patients and reimbursement for companies, rather than postponing the appraisal process to allow for additional clinical data generation.