Will the new CDF operating model impact on patient access to drugs?

Adelphi investigates how oncologists feel the new CDF operating model might impact on patient access to oncology drugs in the UK…

On 25 February 2016, NHS England agreed proposals for a phased and managed transition from the current Cancer Drugs Fund (CDF) to a new operating model.

What’s new?CDF infographic

Under the new system the CDF became a ‘managed access’ fund with a clear entry and exit criteria. All decisions are to be made by NICE who will make one of three recommendations for all newly licensed cancer drugs:

  1. Drug is recommended for routine use on the NHS
  2. Drug is not to be recommended for routine use on the NHS
  3. Drug is to be recommended for CDF funding for a set period of time, until it receives further appraisal from NICE

On 1st April the existing CDF was closed to new oncology drugs, beginning a transition phase across to the new scheme, with a completion date of July 2016.

What impact do oncologists think the changes will have?

We were keen to understand how the changes were being interpreted by prescribers and what impact they might have in real terms, and therefore carried out a poll with 41 practicing oncologists.

A slight majority of oncologists (61%) were already aware of the transition from the old to the new operating model. When informed of the scope of the new operating model it was clear to most (80%) that NICE will have a greater role in CDF decisions.

However, the anticipated impact of the new CDF operating model varied considerably amongst the oncologists surveyed.

  • The majority (71%) felt that the number of drugs patients have access to would be reduced. When asked specifically about access to blockbuster drugs, opinion was less consistent; 42% felt access would be reduced, 34% anticipated no change and 22% believed access would increase.
  • Similarly, perspectives on the impact on speed of access to drugs also varied. The majority (59%) expect a lengthier process, but over a third disagreed – with a good number hoping for a shorter process (22%) and 15% anticipating no change.

Belief in the potential benefits of the new operating model was somewhat underwhelming.

  • There was no clear consensus on the impact, in terms of cost effectiveness. Less than half (45%) believed that prescribing in oncology would be more cost effective as a result of the change. Over a third either anticipated there would be no impact on cost effectiveness (20%) or were unsure what the impact would be (15%). Some (20%), even felt that prescribing would be less cost effective.
  • Views on the impact on patient outcomes were split. 42% anticipated patient outcomes would not improve as a result of the new scheme. Though a similar number (39%) believed that patient outcomes are likely to improve.

What does this mean for UK pharma?

Whilst awareness of the transition was not overly high, it has been clear from this Adelphi commissioned research that Oncologists are starting to contemplate the ‘reality’ of these changes.

However the specific implications of these changes remain unclear and many questions remain unanswered:

  • How might these changes impact the access and uptake of oncology treatments in reality?
  • How might access to blockbuster drugs in particular differ?
  • How will patients, and patient advocacy groups/charities react to these changes? How strong might their voice be?
  • How could this affect the role of private vs public healthcare in Oncology?

At Adelphi we will be watching this progression with interest to understand the extent to which these changes will impact the future treatment and management of oncology – only time will tell…


Even since commissioning this research, we have become aware of further detail of the model which may have considerable implications for manufacturers:

Under the new scheme pharmaceutical companies will be expected to charge cost price for their newly licensed products until NICE provides a decision. For products where the answer is ‘No’, patients already using that drug will need to be funded by the manufacturer.

Overtime NICE will also re-evaluate all drugs currently listed by the CDF, using the new criteria.

Contact us for more information


 

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