September 5, 2008
Cancer Victim is Denied Life-Saving Drug
By Sadie Gray
A cancer sufferer whose primary care trust refused to pay for a drug which could extend his life by up to three years has launched an "end of the road" legal challenge to the decision.If Colin Ross continues to be denied the drug, Revlimid, he will die within a few months, experts say. His lawyers told the High Court yesterday that he was the victim of a postcode lottery.
Mr Ross, 55, said his doctors had requested funding for up to four courses of Revlimid at 5,000 a time. "If I don't win and I get no further treatment, I won't be here for Christmas. It's as simple as that," he said.
He was diagnosed with multiple myeloma, a cancer of the blood cells, in May 2004. Doctors at the Royal Marsden Hospital in London deemed Revlimid to be his last chance after side-effects forced him to give up the other life-prolonging drugs he was taking.
Revlimid is readily available to patients in Europe and the US but has yet to be approved by the National Institute of Clinical Excellence. It is provided by some NHS hospitals but only in exceptional circumstances.
In May, West Sussex Primary Care Trust blocked an emergency application for NHS funding for Revlimid for Mr Ross, saying it was too expensive and his circumstances were not sufficiently exceptional for him to qualify. However, experts including Professor Karol Sikora, a leading cancer specialist, have stated Mr Ross is suitable for treatment. The Royal Marsden keeps a stock of the drug.
Had Mr Ross's home in Horsham been one-and-a-half miles away in any direction, his care would have been the responsibility of a different PCT, which would have prescribed the drug, the High Court was told yesterday. Richard Clayton QC, for Mr Ross, told Judge Simon Grenfell that the trust's decision was "irrational" and it was wrong in its estimate of Revlimid's cost-effectiveness.
"This application for this drug is the end of the road for him," said Mr Clayton. "Either he gets the drug and is able to have life- prolonging treatment, or he does not and treatment ceases, with inevitable consequences."
Mr Ross, who worked in the oil industry, has two children, four grandchildren and a partner who is having radiotherapy for breast cancer. He had already tried two other treatments on the NHS - Thalidomide and Velcade - and although he responded well, side- effects have stopped him from taking them.
Yogi Amin, of Irwin Mitchell, the lawyers acting for Mr Ross, said: "West Sussex PCT managers are denying the funds to pay for this drug because they do not consider Mr Ross an exceptional case.
"Mr Ross is devastated that the NHS will not fund the only treatment available to him. He is frustrated at having had to battle for over nine weeks to get a decision from the PCT managers and we have taken the case to the High Court, with the support of legal aid, to fight for his right to live." Dr Liz Tayler, a public health consultant for West Sussex PCT, said: "When a patient or their doctor requests funding for treatment each individual patient's case is reviewed by a panel made up of clinicians and lay people.
"This panel takes into account a number of factors including information provided by the professionals involved, the evidence of effectiveness from clinical trials and any national and local policies or guidance, including that from cancer networks.
"We have to make difficult commissioning decisions, given that resources within the NHS are limited. The PCT must be satisfied that a drug is both clinically effective and cost effective before it can agree to spend taxpayers' money on that drug."
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