Ring-fencing a budget for cancer drugs: is it fair?

Ring-fencing is defined as protecting funds for use in a specific area. In the National Health Service in the UK, various methods to ring-fence cancer have been employed over the years; more recently the Cancer Drugs Fund in England has enabled cancer drugs that would not normally be considered cost-effective to be provided to patients. This has created variation in provision between England and the devolved countries. While some would argue that ring-fencing allows major advances to be made in the treatment of a particular condition, others would argue that it is intrinsically unfair. In this debate, Graham and Cassidy have written an article arguing the affirmative position and Hughes and Duerden were invited to respond directly to their arguments. As with all the RCPE's ‘Current controversies', the authors have been asked to take a deliberately polarised position and so the views they express may be somewhat overstated.

Keywords Cancer, medicines, funding, NHS, equity, economics

Declaration of Interests Dr Graham, Professor Hughes and Dr Duerden have no conflicts of interest to declare. Professor Cassidy has taken up a post with Roche USA.