Twenty-five different cancer treatments will no longer be funded by the NHS in England, health chiefs have announced.
NHS England announced the step after it emerged the £280m Cancer Drugs Fund – for drugs not routinely available – was to go £100m over budget in 2014/15.
Some drugs will be removed and others restricted – a move charities say could leave some without crucial treatments.
But a Department of Health spokesman said it will allow “new and better drugs” to be offered to patients.
Cancer patients currently receiving the treatments will still be allowed to continue using them.
The restrictions come into place from 12 March and affect a whole range of treatments for breast, pancreatic and bowel cancer.
The most commonly used treatment on the list is Avastin for advanced bowel cancer. The Rarer Cancers Foundation estimates the step will result in more than 7,700 patients losing out.
But NHS England said “difficult decisions” needed to be made and the move would allow some new treatments to be funded.
Fund chair Professor Peter Clark said the review – carried out by doctors, pharmacists and patients’ representatives – had prioritised the treatments with the “best clinical benefit” to get the most out of “every pound”.
The fund will increase to £340m next year, even though the cuts will save £80m a year.
Three treatments have already been added to the list for next year, bringing the total number of drugs that will be available through the fund to 62 from April.
“There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those,” Professor Clark said.
“There were others that offered some benefit but were costly and I am pleased that a number of pharmaceutical firms worked with us to make prices more affordable, saving millions of pounds that can now be reinvested in other treatments.
“These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”
Patients wanting the drugs will be able to apply as an exceptional case.
Owen Sharp, chief executive of Prostate Cancer UK, said the announcement was “just another symptom of a drug appraisal system in meltdown”.
While Mark Flannagan, chief executive of the charity Beating Bowel Cancer, said the decision was “bad news for bowel cancer patients”.
“It’s likely that 65% of patients with advanced bowel cancer face the probability of an earlier death by being refused innovative treatments that were available before,” he said.
Samia al Qadhi, chief executive at Breast Cancer Care, said the Cancer Drugs Fund was “falling apart”, while Stephen Whitehead, of the Association of the British Pharmaceutical Industry, said the move was “extremely disappointing”.
“These medicines have been proven to be effective through clinical trials and have already provided benefit to thousands of NHS patients,” he added.
But Prof Christopher Twelves, a cancer expert at the University of Leeds, said: “The CDF was always a short-term fix and ultimately not sustainable or equitable as it was established.”
A Department of Health spokesman said the fund had already helped more than 60,000 people to access drugs.
Next year, NHS England will spend £340m on the fund to allow patients to get “the drugs they need”, the spokesman added.
“Advances in medical science mean that new medicines are emerging all the time and we want people to have access to the very latest drugs.
“That is why experts have made decisions to stop routinely funding drugs with limited clinical benefit, so we can make way for new and better drugs that offer more to patients.”