Azara Blog: The NHS should allegedly be throwing more money at cancer drugs

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Date published: 2008/08/26

The BBC says:

Some of the UK's top cancer consultants warn that NHS drug "rationing" is forcing patients to remortgage their homes to pay for treatment.

The specialists accuse the government drugs advisory body of "rationing" too severely and call for a "radical change" in the way decisions are made.

Their letter to the Sunday Times also says research success is not being translated into modern treatments.

It follows a decision not to offer some drugs to NHS kidney cancer patients.

Earlier this month, the National Institute of Health and Clinical Excellence (NICE) published its draft guidelines on treatments for patients with advanced kidney cancer.

It concluded that the drugs - bevacizumab, sorafenib, sunitinib and temsirolimus - did not offer value for money.

But in their letter, the 26 cancer specialists say the decision shows how "poorly" NICE assesses new cancer treatments.

"Its economic formulas are simply not suitable for addressing cost-effectiveness in this area of medicine," they write.

They continue: "It is essential that NICE gets its sums right. We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs that are freely available to those using health services in countries of comparable wealth."

The consultants, who include the directors of oncology at Britain's two biggest cancer hospitals, the Royal Marsden in London and Christie Hospital in Manchester, say it is not right the NHS cannot find the money for the drugs.

"We now spend similar amounts to Europe on health generally and cancer care in particular, but less than two thirds of the European average on cancer drugs.

"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."

Find a single doctor anywhere who thinks the NHS spends too much money on his or her pet specialty. It is up to NICE to analyse whether these drugs really are value for money. These consultants do not seem to have any argument against the NICE analysis except that allegedly every other rich country has opted to throw money at these specific drugs. If the consultants think the NHS should throw money at these drugs then they should specify what part of the NHS budget should be cut back in compensation. (Perhaps their exhorbitant salaries, for a starter.) (The BBC should also report whether any of these doctors have any links with any pharmaceutical companies selling cancer drugs.)

Of course this is all part of the perpetual academic middle class complaint that the government should spend more and more money on everything, and let's not worry too much who is going to pay for it all. Indeed, this seems to be cancer propaganda week, because the BBC ran another story along the same lines:

Doctors are keeping cancer patients in the dark about expensive new drugs that could extend their lives, a poll shows.

A quarter of specialists polled by Myeloma UK said they hid facts about treatments for bone marrow cancer that may be difficult to obtain on the NHS.

Doctors said they did not want to "distress, upset or confuse" patients if drugs had not yet been approved by the NHS drugs watchdog NICE.

Primary Care Trusts can provide drugs ahead of NICE approval but many do not.

The National Institute for Health and Clinical Excellence is currently reviewing several treatments for myeloma, including the drug Revlimid (lenalidomide) which trials suggest could extend the life of patients by three years.

One in four of the 103 myeloma specialists in England, Wales and Scotland questioned confessed that they had avoided telling patients about licensed drugs still awaiting approval by NICE.

Again, the BBC offers no suggestion how any of this is supposed to work better. The implication is that NICE should just throw money at pretty much all drugs, and forget any cost benefit analysis.

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