Table 2. Characteristics of Dedicated Funds for Cancer Drugs in Hong Kong, England, and Italy .
| Hong Kong | England | Italy | ||
|---|---|---|---|---|
| Name of a dedicated fund for cancer drugs | SF | CCF Medical Assistance Program | CDF England | Fund for Innovative Oncological and Non-oncological medicines |
| Establishment year | 1950 | 2011 | 2010 (reformed in 2016) | 2017 |
| Objectives | Financial assistance for self-financed drugs and medical devices when patients have a clinical need with access difficulty | Financial assistance for cancer drugs, uncommon disorders and medical devices not covered by the SF before transitioning to SF | Early access to cancer drugs before transitioning to the normal funding mechanism | - Early access to innovative drugs before transitioning to normal funding mechanism - Ensure equity of access to innovative drugs across regions |
| Administrative organization | Samaritan fund management committee | CCF administrative committee | NHS England | SSN |
| Responsible sector | Government and non-government | Government | Government | Government |
| Source of funding | - Government grants - Social Welfare Department - Donations |
- Government - Donations |
NHS England | Central government |
| Annual budget allocated, million USD (% of pharmaceutical expenditure) | 2012: 1300 for 2012 to 2022 (NA) | - 2011-2015: 256 (NA) - 2016: 436 (1.1%) |
1136 which could be crossed paid between oncology and non-oncology drugs (2.4%) - 568 for oncological drugs (1.2%) - 568 for non-oncological drugs (1.2%) |
|
| An annual budget used, million USD | - 2011: 27 - 2012: 31 - 2013: 38 - 2014: 43 - 2015: 47 - 2016: 50 - 2017: 55 - 2018: 54 - 2019: 68 - 2020: 88 - 2021: 110 |
2017: 22 2018: 36 2019: 40 |
- 2013: 359 - 2014: 436 - 2015/2016: 598 - 2017/2018: 259 - 2018/2019: 308 - 2019/2020: 407 - 2020/2021: 431 |
- 2017: 764 - 2018: 1546 - 2019: 1965 - 2020: 2279 |
| Financial administrative organization | Samaritan fund committee | CCF medical assistance program task force | Joint NHS England/NICE/CDF Investment Group | SSN |
| HTA organization | Drug advisory committee | Drug advisory committee | NICE England | AIFA |
| Drug indications covered | Cancer and non-cancer | Cancer and non-cancer | Only cancer | Cancer and non-cancer |
| Coverage scheme | Self-financed items drug with the safety net | Self-financed items drug with the safety net | Conditional reimbursement with further evidence collected to address clinical uncertainties | Conditional reimbursement with further evidence collected to address clinical uncertainties |
| Length of coverage | Not specified (Note: for a patient who is qualified for the drug in SF/CCF, the reimbursement lasts for 18 months after which the patient’s household income will be re-evaluated) |
Not specified (Note: for a patient who is qualified for the drug in SF/CCF, the reimbursement lasts for 18 months after which the patient’s household income will be re-evaluated) |
Normally up to 2 years | - Fully innovative: up to 36 months (same coverage across regions) - Conditionally innovative: up to 18 months (coverage may vary across regions) |
| Cost sharing | Yes | Yes | No | No |
| Patient qualification | Hong Kong Citizens with conditions and indications approved by SF and agree to copay | Hong Kong Citizens with conditions and indications approved by CCF and agree to copay | NHS England eligible patients with conditions and indications approved by the CDF | SSN eligible patients with conditions and indications approved by the AIFA |
| Monitoring and evaluation | Post-approval monitoring and audit | Post-approval monitoring and audit | CDF registry to monitor and evaluate patients’ outcomes | Registry to monitor and evaluate patients’ outcomes |
| Maximum number of covered patients | Not specified | Not specified | Not specified | Not specified |
| Financial control mechanism | Tender | Tender | Financial agreement by NHS England with pharmaceutical companies with input from NICE’s cost-effectiveness analyses | Financial agreement by SSN with pharmaceutical companies with input from AIFA’s cost-effectiveness analyses - MEAs - Confidential discounts |
| Financial control mechanism in the event of budget overspending | The government secured a budget allocation | The government secured a budget allocation | Proportional rebate to all pharmaceutical companies receiving any funding | Rebate to all pharmaceutical companies receiving any funding |
| References | 50,51 | 52,53 | 37,43,54-58 | 59-61 |
Abbreviations: AIF, Agenzia Italiana del farmaco (Italian Medicines Agency); CCF, community care fund; CDF, cancer drugs fund; NA, not applicable; NHS, national health service; NICE, National Institute for Health and Care Excellence; SF, Samaritan fund; SSN, Servizio sanitario nazionale (Italian National Health Service); USD, United States dollar; HTA, Health technology assessment; MEAs, managed entry agreements.
Costs are presented in 2020 USD to comparison.