Postcode lottery fears over cancer drug fund

The fund, which will act as an interim cash supply until a full fund is established in April, is designed to give patients access to non NHS-approved drugs.

But an editorial in The Lancet medical journal today said the fund was not the victory some charities and patient groups believed it was, and many patients could miss out.

It described the fund as the product of "political opportunism", which was "intellectually indefensible" unless emergency funds for other conditions like dementia and multiple sclerosis were also set up.

The criticism comes as the Rarer Cancers Foundation (RCF) condemned the Government's refusal to confirm how much the eventual fund will be worth.

Before the election, Prime Minister David Cameron and Health Secretary Andrew Lansley said the full fund would be 200m.

They said the cash would come from savings on the NHS's national insurance bill to the Treasury.

But last month, Lord Howe said the 200m was an "aspirational figure".

Today, the Department of Health said no final decisions on how much the cancer drugs fund will be worth would be made until the spending review in the autumn. A report form the RCF today said 3,600 cancer patients could miss out on potentially life-extending drugs if the fund was not set at 200m a year.

The cancer drugs fund will pay for medicines which can extend life by a few months or improve quality of life but which may have been rejected by the health watchdog as too expensive.

It will also cover drugs currently used off-label by clinicians to treat conditions not covered by the medicine's licence, or those which have yet to be appraised by the National Institute for Health and Clinical Excellence (Nice).

Doctors in regional groups will decide how the funding is spent in their area based on advice from cancer specialists.

Last month, officials indicated funds may be transferable between different parts of England if one area runs out of money.

The funding is being allocated at a regional level through strategic health authorities. The Yorkshire region will get 5.3m, the North East will get 2.8m and the North West 7.4m.

Today's editorial in The Lancet says patients will now be the victims of decisions made by the health authorities.

"This raises the spectre of appeals being granted or declined not on the basis of patients' conditions, but because of where they live: either because their SHA has exhausted its share of the fund, or because their SHA is using stricter funding criteria.

"Scratch the surface, and it quickly becomes clear that what this fund represents is not the victory for patient groups that some believe. Rather, it is the product of political opportunism and intellectual incoherence."

The editorial says the policy not only undermines Nice but argues it will deter drug companies from lowering the cost of their drugs through NHS patient-access schemes.

"With Ministers claiming that the coalition Government is 'more radical than Thatcher', there is an increasing sense that a desire to force the pace of change is starting to cloud judgment," the editorial says.