The 2016 Cancer Drugs Fund in England

A ‘new’ version of the English Cancer Drugs Fund (CDF) will come into force on July 29, 2016, later than the anticipated April 2016 start. This is the latest evolution of a fund that was first put forward in 2010.
The CDF pays for those cancer drugs that NICE says are not cost effective, or that NICE hasn’t looked at, or those that are in limbo, waiting for NICE’s recommendation.
Reading between the lines it’s clear that companies will need to discount, probably quite heavily, to achieve market access with the prospect of providing rebates too. In return, they’ll potentially get faster NICE appraisal and interim funding from the point of marketing authorization.
With no change to the threshold on cost effectiveness, £20,000 to £30,000 ($26,000-$40,000) cost per Quality Adjusted Life Years (QALYS) in most cases, or up to £50,000 ($66,000) for end of life drugs  the discount required could be significant. (And as an aside, NICE has accepted drugs at a higher cost effectiveness threshold and it seems to have been brought down to the maximum of £50,000($66,000) cost per QALY).
Re-appraisal will likely take place in two years, or perhaps longer, depending on how long data needs to be collected for. Reflecting the fragmented nature of the NHS these days, the discussion for those companies given a maybe NICE recommendation also needs to be with NICE on what evidence will be good enough to inform their re-appraisal in future and Public Health England (PHE) who have the responsibility for the key dataset that is expected to be used, the Systemic Anti-Cancer Therapy dataset (SACT).