title: Does the cancer drugs fund lead to faster uptake of cost-effective drugs? A time-trend analysis comparing England and Wales.
abstract: BACKGROUND
  The Cancer Drugs Fund (CDF) provides £200 million annually in England for 'anti-cancer' drugs.
  
  
  METHODS
  We used a controlled pre-/post-intervention design to compare IMS Health dispensing data for 15 cancer drugs (2007-2012) in England vs Wales, stratified by pre-CDF NICE drug approval status (rejected, mixed recommendations, recommended, not appraised).
  
  
  RESULTS
  The CDF was associated with increased prescribing in England for three of five drugs rejected or with mixed NICE recommendations. The prescribing volume ratios (PVR) ranged from 1.29 (95% CI 1.00, 1.67) for sorafenib to 3.28 (2.59, 4.14) for bevacizumab (NICE rejected) and 0.93 (0.81, 1.06) and 1.35 (1.21, 1.49) for sunitinib and imatinib respectively (mixed recommendations). Post CDF prescribing in England increased for both drugs awaiting NICE appraisal pre-CDF (lapatinib PVR=7.44 (5.81, 9.54), panitumumab PVR=5.40 (1.20, 24.42)) and subsequently rejected. The CDF was not associated with increased prescribing in England of NICE-recommended drugs. The three most recently launched, subsequently recommended drugs were adopted faster in Wales (from pazopanib PVR=0.51 (0.28, 0.96) to abiraterone PVR=0.78 (0.61-0.99)).
  
  
  CONCLUSIONS
  These data indicate that the CDF is used to access drugs deemed not cost-effective by NICE. The CDF did not expedite access to new cost-effective cancer agents prior to NICE approval.
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
authors.forename: C
authors.initials: C
authors.lastname: Chamberlain
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Collin
authors.affiliation: IMS Health, 210 Pentonville Road, London N1 9JY, UK.
authors.forename: P
authors.initials: P
authors.lastname: Stephens
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
authors.forename: J
authors.initials: J
authors.lastname: Donovan
authors.affiliation: Bristol Haematology and Oncology Centre, University Hospitals Bristol, Horfield Road, Bristol BS2 8ED, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bahl
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK.
authors.forename: W
authors.initials: W
authors.lastname: Hollingworth
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004739:England; D006077:Government Agencies; D006297:Health Services Accessibility; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D040841:Resource Allocation / Q000191:economics / Q000379:methods*; D013997:Time Factors; D062505:Value-Based Purchasing / Q000706:statistics & numerical data*; D014852:Wales
chemical_list: D000970:Antineoplastic Agents