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WHAT PRICE A PATIENT’S LIFE?
Cancer drugs are too expensive, but plastic surgery gets go ahead
HEALTH chiefs in Islington are turning down requests from cancer patients for drugs and treatment because they are too expensive.
At the same time, women wanting breast reduction operations have fared better at Islington’s Exceptional Treatment Panel with the Primary Care Trust (PCT) agreeing to fund the procedure.
Sex change implants have also been approved by the panel according to a list of decisions – seen by the Tribune – made in the last year.
The documents show cancer patients hoping to be given ‘wonder drugs’ have had see-saw fortunes when applying for help. Thirteen were granted funding for drugs but ten were turned down for treatment. Some of the medication is awaiting approval from the National Institite of Clinical Excellence (NICE), the national body that evaluates and licenses drugs, even though patients who have undergone trials have reacted positively.
Ian Beaumont, from the charity Bowel Cancer UK, said: “To those who are dying, every second counts and if you’re looking at treatments that can add months to your life, you can have time to get your affairs in order, say goodbye to your family, have that last Christmas.
“To have to fight for the right to have those few months and to have to spend your last month’s fighting is too gruelling.
“What right does anyone, including the PCTs, have to play God with people’s lives?”
Among those rejected by Islington’s panel was a leukaemia patient who wanted an expensive course of Dasatinib, a drug which is still awaiting approval from NICE.
The decision bears similarities to the case of bowel cancer sufferer Gary Russell, highlighted by the Tribune in November.
The father-of-four was forced to raise thousands of pounds himself to pay for immunotherapy drug Avastin.
Mr Russell, who was given six months to live, was told the drug was too expensive for the NHS.
Since beginning the treatment, which costs £18,000 a session, Mr Russell has seen marked improvements in his condition.
Panel members are refusing to disclose the reasons behind individual decisions.
In the past 13 months, the panel has ruled on 64 requests, approved 27, rejected the rest and committed the PCT to spending £375,248.
Around £18,000 was approved for sex change breast implants deemed essential for gender reassignment for one patient, while four women with overdeveloped mammary glands won a total of £16,000 for breast reductions.
The case-by-case approach means other cancer patients have had treatment approved, including £65,420 on lung cancer treatment Erlotinib for five patients.
Last year the PCT saved nearly half a million pounds rejecting requests for “exceptional” treatments including a request for £85,000 of therapy at celebrity rehab clinic The Priory for a patient with obsessive compulsive disorder.
Mr Beaumont said the charity has seen a massive increase in the number of calls from patients since the introduction of the panels.
He added: “Unfortunately the arrival of these new drugs came at a time when the NHS is cash poor, NICE has been created and PCTs are tightening their belts.
“This means these drugs, which could help patients, aren’t getting to many of them.”
He said going through the panel can take its toll on a patient, adding: “It’s a convoluted process.
“The positive side is it can give patients a sense of purpose but it’s not ideal for someone in the advanced stages of the disease to have to be going through this, it can be wearing, it’s an intense process.”
Chris Ward, management director of the North London Cancer Network said: “Inevitably with Exceptional Treatment Panels there tend to be variations in decisions due to individual circumstances. We’re trying to come up with a consistent approach to the funding of pre and non-NICE drugs and are looking at a mechanism to do that.”
Islington’s panel meets monthly but can be convened within 72 hours for urgent cases.
The PCT said decisions are based on effectiveness, appropriateness, efficiency, equity – meaning fairness to other patients – and cost of each treatment request.
The papers released to the Tribune show members agreed to fund one breast implant because of the impact on a patient’s psychosocial health.
Another patient, who has polycystic ovarian syndrome and alopecia wanted hair volumiser therapy to reduce the impact on their social life, but the panel rejected the request, which would have cost up to £24,000 for 12 courses.
Will Huxter, the PCT’s director of strategy and commissioning, said: “Most of what we spend our money on is either with local hospitals or GPs so this is about having a way of considering things which fall outside the system.
“It’s for individual exceptional treatments – there are no targets and no budgetary restrictions for individual patients.”
He added: “There are instances where we’ve given a drug to one patient and not another – there’s a whole range of considerations for each patient.” |
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