What was the main driver for creation of the Cancer Drugs Fund? Its premise, to provide access to drugs not available through the English NHS and hence to bypass the scrutiny of the National Institute of Health and Care Excellence, seemed as unjustifiable in 2010 when it was formed as it does now. Cancer has no miracle cure. Benefits of treatments are not generally well enough established. Indeed, there are persuasive scientific reasons why most current cancer drugs do not work.1 Cancer drugs are lucrative for pharmaceutical companies, and by selling hope companies increase demand from vulnerable patients. Governments for their part are mesmerised by the commercial strength of the pharmaceutical industry and too easily persuaded that innovative regulatory solutions are required to speed new drugs to market.
Enter the media, who might be charged with providing objective analyses but in reality are driven by sales. New cancer drugs make a good story, as does giving hope to people with cancer. Optimism surrounding the latest cancer breakthrough sells, as does the concept of innovative pharmaceutical companies cutting through the red tape of medicines regulation. But rushing new treatments to market is invariably a folly. The evidence base tends to be preliminary. Research dating back to the 1990s tells us that positive studies about new drugs are more likely to be published than negative studies, and those positive studies will be published faster. Any potential harms are quickly passed on to patients as clinicians are tempted by a new product.
All of this was known in 2010 but the coalition government thought it knew better. But if politicians and the media are seduced in future by another innovative scheme to fast track new drugs to market, they should first read this month’s research paper by Richard Sullivan and colleagues.2 Their analysis of media reporting of the Cancer Drugs Fund reaches an unequivocal conclusion: ‘Most press coverage [of the Cancer Drugs Fund] was largely positive and unrepresentative in comparison with the lack of overall benefits to patients and society.’
This month’s commentary also calls for more overt rationing of the NHS.3 But the best way forward might be to favour treatments that stand the test of time, although that doesn’t need to be three and half millennia as in the treatment featured in this month’s article from the James Lind Library.4
References
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- 4.Nunn JF. A treatment that has stood the test of time for over three and a half millennia. J R Soc Med 2018; 111: 377–379. [DOI] [PMC free article] [PubMed] [Google Scholar]