Cancer Drugs Fund requires further reform.

[First paragraph] The reforms to the Cancer Drugs Fund implemented in July were an excellent opportunity to generate evidence on the effectiveness of new cancer drugs.1 Unlike under the previous arrangements, data on patients’ outcomes will have to be collected for all drugs funded by the scheme. However, the reforms’ stated reliance on “real world” (observational) data will not generate reliable evidence of effectiveness. We propose an alternative model, using timely randomised controlled trials within routinely collected data sources, to establish which drugs are relatively effective. The current arrangement encourages early access to drugs, with high prices but uncertain benefits, whereas our proposal will provide high quality evidence for future decisions and therefore larger gains in population health.