Cancer Drugs Fund (CDF)

The Cancer Drugs Fund (CDF) is a way of funding cancer medicines in England. This is before the National Institute for Health and Care Excellence (NICE) approve this treatment for use in the NHS.

In Scotland, Wales and Northern Ireland there are different ways to access new medicines.

What is the Cancer Drugs Fund?

The CDF is part of the NICE process for reviewing new cancer medicines. NICE aims to review all new cancer medicines within 90 days of them getting a licence for use in England. It also assesses medicines used to treat rare cancers. 

NICE makes one of 5 decisions about whether a medicine should be available:

• recommended - the medicine should be routinely available 
• optimised – the medicine is only available for certain people with a condition
• recommended for use within the cancer drugs fund (CDF) - the medicine can become available via the CDF so that we can be sure it is effective 
• only in research – you can only have the medicine as part of a clinical trial, so researchers can collect more evidence about how well it works
• not recommended - the medicine should not be available 

'Recommended' decision

When NICE recommend a medicine, it goes into the CDF for a short period of no more than 90 days until the decision is confirmed.

Once the NICE decision is confirmed, it leaves the CDF. It then becomes routinely available. This now means that the medicine is available immediately. 

‘Not recommended’ decision

A 'not recommended' decision means that the medicine doesn't work well enough. Or it doesn't fulfil the value for money criteria set by NICE. So it is not approved for use in the NHS and can't be provided under the CDF.

'Recommended for use within the CDF' decision

‘Recommended for use within the CDF’ means that the medicine shows promising results in trials. But there isn't enough evidence to recommend it at the moment. There is then more time to collect evidence about how well it works. Reviewers can also decide whether it meets the value for money criteria set out by NICE.

After a period of up to 2 years in the CDF, NICE reconsiders the medicine and makes a final decision whether to recommend it or not.

The aim is to give doctors quicker access to new treatments for their patients.

How long does it take?

Once a medicine has a licence, NICE should make its decision within 90 days.

This means you can get the medicine quickly if you need it. This should make it easier for you and your doctor to understand what is available.

A decision may also be made about how long a medicine should stay on the CDF list. Most drugs will only remain in the CDF for a short period.

Some medicines may stay for longer if doctors think they need to get more evidence about how well it works. And whether it is value for money. Generally, it is a maximum of 2 years

Medicines available

You can see information about what medicines are on the CDF list and when they might be used. This might be:

• for a certain type of cancer
• for a certain stage
• only in advanced cancer
• only if they have tried other treatments first

Applying to the Cancer Drugs Fund

Your specialist applies to the CDF for you. They fill in a simple form online.

You can't apply yourself directly. Your cancer specialist is in the best position to suggest what treatment is best for you. They make a decision based on:

• your type and stage of cancer
• any treatments you have had before
• your general health

Once your specialist has submitted the form, they will get confirmation whether you can start the treatment.  

Scotland, Wales and Northern Ireland

The Cancer Drugs Fund is only available for patients in England. You have to be entitled to routine NHS care in England. You also have to be registered with a GP in England.

Access to new medicines is different in Scotland, Wales and Northern Ireland.

Scotland

In Scotland, there is the Scottish Medicines Consortium (SMC). It aims to make sure that people have the same access to treatment wherever they live in Scotland.

Scotland has its own 'new medicines fund'. This fund pays for some medicines for patients with rare or end-of-life conditions.

Wales

The All Wales Medicines Strategy Group (AWMSG) makes some decisions for the NHS in Wales. Generally, it follows NICE decisions.

The Welsh Government has the 'new treatment fund’ for Wales. This aims to speed up patient access to new treatments.

Northern Ireland

Health and Social Care Services in Northern Ireland follows NICE cancer drug fund decisions.

Other options

Talk to your specialist if you think a treatment might help you but it isn’t available. There might be other ways to access treatment. These include:

• individual funding request (IFR)
• clinical trials
• private medical treatment

Coping if you can’t have a cancer drug

You might feel disappointed if you can’t have the treatment you would like. This can be very difficult to come to terms with. You might feel a range of emotions, including anger.

It can be helpful to talk to your specialist. Or you might be able to talk with other people who have tried to get the same treatment. It can be helpful to share experiences.