August 25, 2008
?Patients Must Remortgage to Pay for Cancer Medicine?
By Nicola Fenwick
CANCER experts have accused a health watchdog of forcing patients to remortgage their homes to pay for treatments freely available in Europe.The group of 26 professors are dismayed at guidance issued by the National Institute for Health and Clinical Excellence (Nice) that deny four kidney cancer drugs on the NHS.
Earlier this month, Nice said the drugs + Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) ? were not cost-effective.
The Northern Echo has been highlighting the struggle faced by North-East and North Yorkshire cancer patients to obtain these drugs, with a campaign called End NHS Injustice.
The Department of Health allows all fully licensed new drugs to be prescribed by doctors ? but they can only do this if their primary care trust (PCT) agrees to pay for the drugs.
This has led to long delays in new drugs being approved for the NHS and a postcode lottery, with some PCTs prescribing and others refusing.
No one knows this better than Barbara Selby, a 64-yearold former nurse from Richmond, North Yorkshire.
North Yorkshire and York PCT have refused to pay for Sutent.
Yet fellow kidney cancer sufferer Kathleen Devonport, a mother- of-three and grandmother of six, from Chilton, County Durham, can get the drug.
This is because last August, all the PCTs in the North-East and Cumbria acknowledged the value of Sutent and agreed to pay for it.
Before then her life was prolonged by a benefactor who paid [pounds]9,000 for threemonths of treatment.
In a letter to the Sunday Times, the consultants said they were dismayed at the rationing of the drugs for advanced kidney cancer.
They wrote: ?Once again Nice has shown how poorly it assesses new cancer treatments. Its economic formulae are simply not suitable for addressing cost-effectiveness in this area of medicine.
?Mean survivals obscure the fact that some patients will obtain prolonged benefit from these drugs.
?We have already seen distraught patients remortgaging their houses, giving up pensions and selling cars simply to buy drugs that are freely available to those using health services in countries of comparable wealth.
?It just can?t be that everybody else around the world is wrong about access to innovative cancer care and the NHS right in rationing it so severely. ? The professors said the NHS spent less than twothirds of the European average on cancer drugs and it was a tragedy that Britain?s leading role in cancer research was not being translated into treatment for all patients.
Liberal Democrat MP Dr Evan Harris said the consultants were aiming at the wrong target.
The former hospital doctor said: ??Rationing is an inevitable consequence of a mismatch of NHS funding to health needs and the only fair ways to change the situation are either to elect politicians who provide more NHS funding, or to propose an alternative equitable way of calculating cost-effectiveness.
??Attacking Nice is simply shooting the messenger and letting politicians off the hook. ? Defending Nice, chief executive Andrew Dillon said: ??We havemade it possible for thousands of cancer patients to receive treatment when, without our guidance, they would almost certainly have not.
??It therefore cannot be the case . . . that our methods for valuing new treatments are unsuitable for cancer drugs.
??The provisional conclusions on the use of drugs for treating renal cancer are those of an independent appraisal committee whose membership is largely drawn from NHS clinicians in active practice.
??They understand the issues at stake. They themselves are often involved with the care of patients with cancer, but they are also involved in the day-to-day care of patients with other conditions, many as distressing for those who live with them as cancer. ??
He said that for the oncologists to maintain the credibility of their argument they needed to explain which patients with other diseases ?should forgo cost-effective care in order to meet the needs of those with renal cancer?.
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