August 18, 2008

Setback in Fight for Cancer Drugs

By Gavin Engelbrecht

THE Government?s drugs approval agency warned last night it might not be able to meet a pledge to speed up decision-making on new treatments.

Campaigners and patients have criticised Nice ? the National Institute for Health and Clinical Excellence ? over the time it takes to approve lifegiving drugs.

Health Secretary Alan Johnson has pledged to bring decision- making on new drugs down from an average length of two years to only three months. But Andrew Dillon, the chief executive of Nice, provoked consternation last night when he admitted the organisation might not be able to hit the Government?s target.

The admission will come as a blow to thousands of terminally-ill patients waiting for new treatments to be given the go-ahead.

In Scotland, where drugs are approved by the Scottish Medicines Consortium, there is a three-month target for initial decisions.

In England, the wait ismeasured in years, not months.

Mr Dillon also caused a furore when he blamed local health trusts for creating a drugs lottery.

After drugs are granted a licence in England, they still have to be approved by Nice before being prescribed routinely throughout the NHS.

But individual primary care trusts (PCTs) can opt to pay for drugs before they are given Nice approval, depending on the circumstances.

This apparent anomaly ? and an average waiting time for Nice approval of nearly two years ? has given rise to a situation where a patient can be given a drug while someone only a few miles away is refused.

In this region, kidney cancer patient Barbara Selby was denied the drug Sutent because she lives in Richmond, North Yorkshire.

NHS doctors in County Durham ? seven miles away ? were given permission to prescribe the drug, following a decision by the local PCT.

In a further twist, earlier this month, Sutent was effectively banned for all NHS patients when Nice ruled it was not cost- effective.

Last night, Mr Dillon blamed PCTs for the confusion.

He said they should be consistent when deciding whether to make funds available for medicines that have not been given the go-ahead by Nice.

He said: ?It shouldn?t make any difference where you live.

?There ought to be a common basis for making decisions about exceptional circumstances, and I think anybody who uses the NHS for their care is entitled to expect that.

?What patients need to do is to find out from those who are making the decision what the basis of that decision is, and if they don?t think it?s reasonable, if they don?t think it compares appropriately with decisions that are taken elsewhere, ask ?why not? ??

Mr Dillon?s comments, to be shown on BBC1?s Panorama programme tonight, provoked anger among North-East patients.

County Durham patient Kathleen Devonport, who spent months fighting to get Sutent on the NHS, said: ?They keep coming up with things to say, but nothing concrete is happening. It is all hot air. They keep saying they are going to stop the postcode lottery, but nothing has been done about it. ? The 65-year-old, who lives in Chilton, County Durham, added: ?People need the drugs when they need them ? not in six months? time or longer. By then it may be too late.

?They are putting things back all the time. In the meantime, people are dying.

It is just a way of saving money. ?

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