OBJECTIVES: The CDF enables interim reimbursement during ongoing data collection, thus facilitating patient access where there is uncertainty in the evidence base. The objective was to review the time to guidance with oncology products and establish whether a recommendation for funding within the CDF might take longer to obtain than a recommendation for routine reimbursement or whether proactively seeking a CDF recommendation could shorten the time to guidance.

METHODS: We reviewed all oncology appraisals conducted by NICE since 2016 to assess the CDF and the appraisal process. We examined the number of products receiving each appraisal outcome, the length of time products spent in appraisal, the number of committee meetings before decision and whether a proactive approach to the CDF affected these.

RESULTS: Since 2016, 13 oncology products have been recommended for use within the CDF, 53 have received routine reimbursement and 15 were not recommended. The mean appraisal time of products assigned to the CDF was 17 months (range 10-36 months). Recommended appraisals took a mean time of 22 months (range 3-92 months). Restricted recommendation appraisals took a mean time of 21 months (range 8-74 months), and non-recommendations took a mean time of 11 months (range 4-18 months). Products entering the CDF required between 1 and 3 appraisal meetings, as did restricted recommendations. Non-recommendations required 2-3 meetings, recommended products 1-4 meetings to appraise. The shortest CDF appraisal was one, in which CDF status was proactively sought.

CONCLUSIONS: Positive CDF appraisals are quicker and usually take fewer committee meetings than non-CDF appraisals. A proactive approach to CDF may reduce appraisal time in some cases. Neither indication, nor reason for CDF assignation were seen to affect appraisal time significantly. Many more oncology drugs receive a full recommendation than CDF or restricted, primarily due to stronger supporting evidence and data submitted.