Mismanagement of the £1.3 billion Cancer Drugs Fund has led to dying patients missing out on key medication, according to information provided by MPs.
A damning report by the Public Accounts Committee indicates that the fund has been malfunctioning significantly over the last five years.
The budgeting of the organisation has clearly got out of control, and this has led to the health service paying extremely high prices for medication.
The report concluded that “there is no assurance that the Department of Health and NHS England are using their buying power effectively to pay a fair price for cancer drugs. The companies were clearly prepared to reduce their prices to help keep their drugs on the fund’s list.”
One only needs to look at the figures related to the cancer drugs fund in order to understand the extent to which it has grown beyond its original remit.
Its initial budget had been capped at £175 million per year, but this has subsequently risen to in excess of £415 million.
The report documents this, and also explains the consequences of this vast increase in expenditure.
“To help cover this overspend, NHS England had to defer some planned spending on primary care services. NHS England did not start to take action to control costs until November 2014. Since then it has reduced the number of drugs available through the fund.”
Despite the failings of the fund, the report does nonetheless conclude that 80,000 people have received medication through it since it was launched.
But the figures are extremely damning for the fund, and suggests that its future will be reviewed as a matter of urgency.
Meg Hillier MP, chair of the committee, commented that there had been fundamental economic failings within the fund during the five years that it has operated.
“Clearly they weren’t watching the money. As the costs went up they rapidly delisted, which shows a sign of lack of control. Every time they overspent and had to cut back, that affects patients. If they had managed it better there would have been more benefit for many more patients. It was chaotic.”
Hillier continued by pointing out that the fund had fundamentally failed cancer sufferers in particular.
“One of the reasons for the fund was to focus on rare cancers, but those rare cancers have lost out because more money has been spent on the bulk cancers which should have gone through [routine funding routes].”
An NHS England spokesman commented “This report comes just a day after new independent figures showing the NHS’ great success in improving cancer care and survival rates for patients across England. While we welcome the committee’s support for a redesigned cancer drugs fund, we hope their explicit call for cuts to cancer drugs prices charged to the CDF will be borne in mind as complex decisions on its future are taken in the next few months.”
Overall prescribed medication costs in the NHS total nearly £15 billion.
The Cancer Drugs Fund in England has announced that it is to effectively eliminate a raft of medicines that have previously been utilised in cancer treatment.
This will effect 16 medicines that have previously been used in no less than 23 cancer treatments.
With this latest decision, the Cancer Drugs Fund has taken the radical action of effectively more than halving the number of treatments it covers.
The fund had suffered from repeated budgetary difficulties, and this has been the primary motivation to reduce the number of cancer medicines that it deals with.
Among the pharmaceutical products axed by the fund are medicines that treat breast, pancreatic and blood cancers.
Although there is an underlying economic motivation for the decision, it is not one that has found uniform favour.
The Rarer Cancers Foundation (RCF) was particularly critical of the action of the Cancer Drugs Fund, describing the news as a “hammer blow” for cancer sufferers.
As a result of the decision made by the fund, the RCF estimated that 5,500 patients would no longer be able to receive critical cancer treatment.
Yet defenders of the decision claim that the drugs do not provide sufficient assistance to cancer sufferers in order to justify their requisition after a cost-benefit analysis.
The Cancer Drugs Fund was originally set up by Prime Minister David Cameron with the specific remit of providing access to cancer medication.
However, NHS England reported that the fund was £100 million over budget in 2014-15.
Discussing the financial problems that the fund faces, Prof Peter Clark, the chairman of the Fund, stated: “There is no escaping the fact that we face a difficult set of choices, but it is our duty to ensure we get maximum value from every penny available on behalf of patients.
“We must ensure we invest in those treatments that offer the most benefit, based on rigorous evidence-based clinical analysis and an assessment of the cost of those treatments.”
NHS England claims that without significant delisting of drugs, the budget of the fund will increase further during the current financial year, reaching approximately £410 million in total.
Yet despite the economic arguments proffered for the delisting, Andrew Wilson, chief executive of the Rarer Cancers Foundation, was strongly critical of the action.
“These cuts will be a hammer blow to many thousands of desperately ill cancer patients and their families.
“Ministers told us they wanted to work with charities to develop a solution, but now the NHS has announced big reductions in access to existing life-extending treatment, with no action to make available the newest game-changing drugs.”
The charity Breast Cancer Now also described the day as a “dreadful” one for patients.
Over 150,000 people die from cancer in the UK every year.