UK's 'NICE' Rejects More Cancer Drugs as Too Expensive

[Guest guest]

[i had an interesting discussion with a renal oncologist, who said

these drugs have 'revolutionized' his practice by offering, for the

first time, effective treatment for metastatic kidney cancer patients.

He said that some patients have experienced remissions for several

years, although the median survival is shorter than that. A shame.]

Drug denial is devastating 'death sentence' for cancer patients

By Hope

Campaigner: Broadcaster and kidney cancer survivor Whale called

the decision 'barbaric'

Thousands of kidney cancer patients have been handed an 'early death

sentence' under plans to ban life-extending new drugs.

Four drugs which can offer patients extra years with their loved ones

have been rejected by the Government's rationing body because they

cost too much.

The National Institute for Health and Clinical Excellence admits the

drugs work, but says that if they are approved, patients with other

diseases will have to go without.

Campaigners claim the Health Service is being plunged into the Dark

Ages, as other western European countries use the drugs as standard.

Instead, NICE has limited treatment to a drug called interferon that

doctors claim is ineffective for 75 per cent of patients.

Kidney specialist Tim Eisen, professor of medical oncology at the

Cambridge Research Institute, said: 'Patients here are receiving

medieval treatment.

'Together these drugs are the single greatest advance for kidney

cancer patients in the last 20 years, yet I and my colleagues face the

prospect of being unable to offer treatment that is absolutely

standard in every other western European country.'

'This decision will mean that the UK will have the poorest survival

figures in Europe.'

The ban is the latest controversial move by NICE, which has already

seen its decision-making process in restrictions on Alzheimer's drugs

successfully challenged in the High Court.

Hope: Cancer patient now has access to the drug thanks to

an anonymous donation

Instead doctors will be forced to offer interferon - a medication of

such limited use that it is prescribed for just one in ten patients in

some cancer units.

Pfizer, which makes Sutent, the only oral treatment to show survival

rates of longer than two years, says it costs around £24,000 for a

year's treatment.

NICE says the additional cost of one year of healthy life gained by a

patient can reach £171,000.

But kidney specialists believe this proposal is a watershed because it

requires them to act unethically, offering a lower standard of care

than elsewhere in western Europe and the US.

Altogether 7,000 people are diagnosed with kidney cancer each year.

About 3,600 patients living with an advanced form of the disease are

eligible for the new drugs, which work by stopping the cancer cells

from multiplying and cutting off the tumour's blood supply.

Radio broadcaster Whale, who lost a kidney to cancer in 2000,

said the guidance would 'mean an early death sentence for many'.

He said: 'I think it's barbaric and it's politically motivated, in my

view.'

Pat Hanlon, of Kidney Cancer UK said: 'This draft recommendation will

have a devastating impact on patients with advanced kidney cancer, as

it could result in a life or death situation.'

Previously some primary care trusts agreed funding for patients under

'exceptional circumstances' appeals.

Other patients are paying for drugs themselves.

One sufferer, mother of three , 62, from Manchester, had

her drugs funded by an anonymous donor after the NHS turned her down.

Professor Littlejohns, clinical and public health director at

NICE, said: 'NHS resources are not limitless.

'If these treatments were provided on the NHS, other patients would

lose out on treatments that are both clinically and cost effective.''

Craig Dunn was diagnosed with advanced kidney cancer in February last

year.

The disease had spread to his lungs, liver and chest, for which he

needed treatment after his kidney was removed. But the drug interferon

had no effect on the tumours.

Mr Dunn, 47, of Hinckley, Leicestershire, read about Sutent in the

Daily Mail.

But Leicestershire Primary Care Trust was not routinely funding the drug.

Sutent

Saved: Craig Dunn, with his wife Helen, says Sutent worked for him

He said: 'I applied for funding on the basis of exceptional

circumstances and the PCT agreed to match a free cycle of treatment by

the drug company, so I had two cycles.

'The scans then showed the main tumour affecting my chest and heart

had completely vanished and the tumour in my lung had reduced

considerably.'

A year later he has had his ninth cycle of treatment, and shows no

detectable signs of the disease. He is already back at work as a

designer for Aston .

Mr Dunn said: 'I think it would be grossly unfair if other kidney

cancer patients don't get the opportunity to try the drug, as I did.'

How can you put a value on a few extra months of life?

Dr Scurr writes:

According to one of the country's top oncologists, Dr Maurice Slevin,

Sutent is the best drug there is for advanced kidney cancer and liver

cancer.

It can add months to the lives of patients facing an imminent death -

perhaps two, perhaps 12, or even more.

Dr Scurr

Excellent drug: Dr Scurr backs the use of Sutent

The fact is, you don't know until you've tried it.

So why has the National Institute for Clinical Excellence indicated

that it won't be allowed on the NHS?

The answer is that it thinks kidney cancer patients aren't worth the

money.

Of course there has to be some rationing in the healthcare system.

There always has been --the cake just isn't big enough.

In the old days rationing was achieved with waiting lists. Waiting to

see a specialist meant patients often died, or went privately, or even

got better.

But although they kept the costs down, waiting lists became a

political football and are now generally viewed as unacceptable. So

how else could the spiralling cost of drugs be kept down? This is

where NICE came in.

NICE talks about evaluating drugs according to their excellence, but

with Sutent their cover has been blown.

This is an excellent drug. So too are some of the other drugs NICE has

recently rejected for NHS patients, including the anti-TNFs for

rheumatoid arthritis and Aricept for Alzheimer's (which I rate so

highly that my own father is taking it).

Indeed, when you look at NICE's recent decisions what emerges is a

picture of drugs being assessed not according to their excellence, but

rather, their cost effectiveness (in fact many medics now refer to the

organisation as the National Institute for Cost Effectiveness). But

how can you put a value on those extra few months of life?

And it's not just about the extra time that drugs such as Sutent give

patients, it's about the quality of that extra time - reducing pain so

that people can get back to some semblance of life, whether it's

playing bridge, or even working.

The alternative for kidney patients is palliative care. What that very

often means is using drugs that will make patients drowsy.

It may be that the solution to the need to ration is to allow a system

of co-payment, where patients top up the extra cost of expensive

treatments.

But just as important is the need for our healthcare service to be

truly independent.

NICE is supposedly so, but to many doctors it seems that its agenda is

determined by budgetary concerns and therefore politics.

And it's patients who are paying the price.