While the Cancer Drugs Fund has benefited more than 60,000 patients since it was established in 2010, it makes no sense. It was created as a buffer for politicians from both the health technology assessment carried out by NICE and from individual patient decisions. Prime Minister David Cameron pledged – as an election promise – that any patient could get any drug provided their consultant made the request, but times have changed. This clearly could never work in an era of dramatic super-inflation with little meaningful survival benefit.

The more we spend on healthcare the better the outcome. But there’s a vertical limit, a therapeutic plateau, where the benefit begins to dwindle. And we see this with the current delisting of 25 treatments under the CDF. All the delisted drugs were unduly expensive without giving meaningful clinical gain. Of course, personalised medicine strategies with molecular signatures could change this but very few drugs actually have specific response markers to guide therapy.

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