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UK drugs appraisal system denies cancer patients leading treatments

UK drugs appraisal system denies cancer patients leading treatments

Thousands of NHS patients are missing out on cancer treatments available in other countries as UK drugs appraisal systems lack power to negotiate prices.

A new report by leading charities Breast Cancer Now and Prostate Cancer UK shows NHS cancer patients in the UK are missing out on treatments available in countries of similar wealth.

The report shows this is likely in part because UK appraisal systems, like the National Institute for Health and Care Excellence (NICE), are unable to negotiate the price of drugs.

The report, International Comparisons of Health Technology Assessment, reviewed the drug systems and the availability of breast and prostate cancer treatments in England, Scotland and Wales compared to five similar countries: Germany, France, Australia, Canada and Sweden.

In the non-UK countries there is a split between two bodies: the Health Technology Assessment (HTA) body that assesses the clinical effectiveness of a drug and another body that decides whether it is cost-effective.

In these other countries, one HTA body makes clinical recommendations that then inform negotiations between government bodies and pharmaceutical companies.

However, NICE, in England, and the Scottish Medicines Consortium (SMC), in Scotland, have responsibility for both functions.

NICE has not approved a single new breast cancer drug for routine use on the NHS in the last seven years, while just two treatments have been approved by the SMC in that time.

For example, Kadcyla, a drug that can offer women living with incurable secondary breast cancer an extra six months of life, was launched two and half years ago and is now available in Germany, Canada and France.

But in England it is only available through the Cancer Drugs Fund and it is not available at all in Scotland or Wales.

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “That NHS patients are being denied access to innovative new breast cancer drugs, while other countries are finding ways to make them available, is totally unacceptable.

“This report demonstrates the need for serious reform of the way our health system assesses, and determines the availability of, the cancer drugs that patients rely upon.

“Pharmaceutical companies must indeed start offering more responsible prices. But until our health bodies are empowered to negotiate the price of cancer drugs, patients in the UK will continue to miss out on new treatments being offered elsewhere.

With the Cancer Drugs Fund (CDF) having changed in July 2016, the new Fund will put its assessment of new drugs in England entirely back into the hands of NICE, whose repeated rejections of new cancer treatments was what the previous CDF was set up to address. 

Breast Cancer Now and Prostate Cancer UK are calling on the Secretary of State for Health to review the role of NICE and the Pharmaceutical Pricing Regulation Scheme in time for 2018 so that price negotiation can be brought into the system.

Heather Blake, Director of Support and Influencing at Prostate Cancer UK, said: “Making all new cancer treatments available to patients is of course made challenging by finite NHS budgets that are stretched to capacity and running at a deficit.

“But men cannot continue to spend years fighting for access to every new prostate cancer treatment. They need a more streamlined system for assessing and appraising cancer drugs which makes the right decisions first time around.

“Although last month’s CDF reforms aim to address this issue, they place all the responsibility for patient access to new and innovative treatments on the pharmaceutical industry’s willingness to lower its prices meaning that cancer patients once again have the potential to be left in limbo.”

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Thousands are missing out on cancer treatments available in other countries because the UK system cannot negotiate prices