NHS holds up cancer drugs

The UK has one of the worst records over access to cancer drugs as stark inequalities exist across the world, a Swedish study says. Researchers ranked the UK in the bottom group for its "slow and low" uptake of drugs after analysing the sales of 67 treatments in 25 countries. The US, Austria, France and Switzerland were the best, the Karolinska Institute and Stockholm School of Economics said. But the UK government said it had speeded up the drug approval process.

The researchers said getting new treatments to patients quickly and in large numbers was reflected in the survival rates. France had the highest five-year survival rate in Europe at 71% for women and 53% for men, compared to 53% and 43% in the UK respectively. The research was funded by drugs firm Roche, but independent experts said that did not invalidate the findings.

The greatest differences in uptake, measured by the proportion of patients given the drugs and how quickly they came on to the individual markets after being produced, was seen in bowel and lung cancer drugs. The US's uptake of bowel cancer treatment bevacizumab was 10 times the European average, the researchers said. In Europe the likes of France and German had higher than average use, compared to "very low" in Italy and the UK.

For lung cancer, uptake of erlotinib was 10 times higher than the European avearge in the US and three times higher in Germany. Uptake in Australia, the UK, Norway and Poland was slow.

In the UK, the first sale of breast cancer drug trastuzumab was in autumn 2000, nearly two years after it hit the market in the US and a full 12 months after it was given in Switzerland and France. Along with the UK, New Zealand, Poland, Czech Republic and South Africa were ranked at the bottom of the overall league.

Lead researcher Dr Bengt Jonsson said: "It is our hope that this report will inspire policy-makers and decision-makers to take action to address these imbalances so that access to new innovative cancer drugs does not become dependent on the patient's couintry of residence. "Cancer research continues to grow, with many new drugs and treatments expected to be introduced in the coming years. "Countries need to address urgently how they are going to accommodate newer drugs into health care systems and pay for them."

In the NHS, the National Institute for Health and Clinical Excellence (NICE) has responsibility for recommending if new drug treatments should be provided by the health service. The system has been heavily criticised because of a backlog in assessing treatments and for restricting access to them. But a Department of Health spokesman said NICE was essential in ensuring that the NHS used the most effective treatments. And he said measures had been taken to speed up the approval process for key drugs. "We are making good progress in ensuring cancer patients have access to the drugs they need. "For example draft guidance was available within two weeks of Herceptin for early breast cancer being licensed." [And the guidance was not to use it generally!]

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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