Access to treatment
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.
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.
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
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
Look at the latest drugs fund list on the NHS England website
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.
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.
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.
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.
Visit the All Wales Medicines Strategy Group (AWMSG) website
Health and Social Care Services in Northern Ireland follows NICE cancer drug fund decisions.
Visit the Northern Ireland Department of Health website
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
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.
Visit Cancer Chat, our online forum
Last reviewed: 03 Jan 2024
Next review due: 04 Jan 2027
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Sometimes there are treatments which aren’t available on the NHS. There are other ways you might be able to access a treatment that isn’t available on the NHS.
Drugs go through a review process. This ensures they're safe, effective, and that the benefits outweigh possible side effects.
Once a medicine has a licence, organisations will decide if it should be available as part of free healthcare.
There are several decisions to be made about a cancer treatment before you can have it on the NHS or HSC.
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What to ask your doctor about clinical trials.
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