OBJECTIVES: According to a report from the Rarer Cancers Foundation of England, within the first six months of the launch of the Cancer Drugs Fund in England, only £ 27,437,466 were used while the total amount allocated for the same period was £50,000,000. This means that only a 56% of allocated funds for that period were used. In a health system that restricts access to those oncological treatments that have not shown to be cost-effective or have not been assessed by NICE a more optimal use of the available funds would have been expected. In this study the authors try to explore and determine the possible underlying reasons for the observed underspent of allocated budget within the Cancer Drugs Fund in England from October 2010 to March 2011.  METHODS: Interviews were conducted across different SHAs (Strategic Health Authorities) in England (n=5) in 2011. A specific questionnaire was designed to conduct this research RESULTS: Majority of respondents mentioned delays in application for drug funding, miscalculation of expected number of application by clinicians, among other reasons for underspent of Cancer Drugs Fund CONCLUSIONS: SHAs should make sure that funds are properly allocated and used in the benefit of patients and no application should be rejected in the basis of an economic reason but just on pure clinical reasons