On 28th November 2014 the BMJ published the Editorial “Reforming the Cancer Drug Fund”. In this editorial, Buxton, Longworth, Raftery, Sculpher and Towse argue that the CDF, with new arrangements for prioritising access to it “will continue to undermine NICE, duplicate effort, and distort allocation of NHS resources while failing to support the development of cost effective drugs from which patients could benefit.”
They argued for a better process which uses a variant of “coverage with evidence development” when appropriate. More specifically: “the fund should focus on those cancer drugs that may be cost effective but for which current evidence is insufficient…helping to identify those promising cancer drugs for which more research could reduce the uncertainty about cost effectiveness”. The CDF would pay for commissioning (where use with research was practicable) and the company would (usually) fund and undertake the research. Flexible pricing agreements might be needed. NICE would lead in the process. It would conduct the initial review, identify the additional research required, and conduct the subsequent review.
In the BMJ blog post “Why has the PROMs programme stalled?” (3rd December 2014), Nancy Devlin, John Appleby, and David Parkin argue that the PROMs programme, despite having huge potential to drive improvements in quality of health care, is stalling. They explain that “Literally millions of data points have been collected” but that focus has been lost, meaning the programme has simply “rumbled along”. The authors appeal for the “full and passionate” support of policy makers for PROMs, and “a renewed commitment to putting health outcomes at the heart of healthcare decisions”.