OBJECTIVES: Oncology drugs in England rejected or not yet assessed by the National Institute for Health and Care Excellence (NICE) can seek funding through the Cancer Drug Fund (CDF). Each drug is given a score via the national CDF Prioritisation Tool which is a clinically-led process where cost-effectiveness is considered only as a tie-breaker. The objective of this research was to determine which score secures CDF approval and how the decision is related to the Incremental Cost Effectiveness Ratio (ICER). METHODS :  CDF drug reports (including the scores) published from April 2013 until March 2014 were analysed and mapped to the national May CDF list. Each score comprises of a number indicating the clinical profile of the drug and the letter (A-D, U) representing the strength of evidence. The ICER per indication was sourced from NICE assessments and the relationship to the CDF list was analysed. RESULTS: A review of 56 CDF reports showed that generally, drugs with scores below 1B (positive clinical profile, one Phase III published study) were not granted CDF funding. Positive decisions were made for 19 indications with scores ranging from 1B to 8B. The most common reasons for not approving drugs with a score of ≥1B were the trial not representing the NHS England population; lack of clinical effectiveness or questionable wider clinical support. The ICERs does not appear to have an influence on the CDF decision as ICERs for both CDF and non-CDF drugs ranged from £30,000 to £150,000. CONCLUSIONS: The result of this research confirms that the clinical profile and the level of evidence are the most important factors for the CDF inclusion while cost-effectiveness is not a standard part of the decision-making process. The findings can also support manufacturers in estimating the likely outcome of the CDF application based on the pre-calculated score.