National Audit Office 17 September 2015
- Some of the key findings of the investigation:
- 51% of the patients supported by the Fund between April 2013 and March 2015 accessed drugs that were appraised by NICE but not recommended for routine NHS commissioning because they did not meet its clinical and/or cost-effectiveness thresholds.
- Due to a lack of data, it is not possible to evaluate the impact that the Fund has had on patient outcomes, such as survival. However, a data sharing agreement between NHS England and Public Health England, signed in July 2015, should enable the outcomes of patients supported by the Fund to be tracked.
- NHS England has taken action to control the rapid growth of the cost of the Fund, including removing drugs on the grounds of cost for the first time. In March 2015, it stopped providing access to some drugs after a review of clinical effectiveness and cost, and in September 2015 it announced that it was proposing to remove more drugs from the national list of available drugs.
- All parties agree that the Fund is not sustainable in its current form. In July 2015, NHS England proposed that the Fund should become a ‘managed access’ fund that pays for promising new drugs for a set period before NICE decides whether the drugs should be routinely available on the NHS. The implication is that the Fund would no longer support the provision of drugs that have been appraised but not recommended by NICE. NHS England plans to consult on its proposals in autumn 2015, with the aim of implementing the new arrangements from April 2016.
