In a fantastic and timely piece of news for thousands of people with cancer, the health secretary Alan Johnson has announced a package of measures that will greatly increase the availability of new cancer drugs in England and Wales.
We believe that this announcement is great news for patients and their families, as it deals with some of the long-running and controversial issues that have dominated headlines over the last year.
Here’s a run-down of some of the most significant parts of what’s been announced.
A significant raise in the ‘cost per QALY’ threshold for drug approval
NICE, the organisation which decides on the cost-effectiveness of new drugs, does so according to a mathematical model that assesses the cost per ‘quality adjusted life year‘ (‘QALY’ – essentially a measure of length and quality of life added by the drug), and compares this to a predetermined threshold.
If the ‘cost per QALY’ is higher than the threshold, the drug doesn’t get approved. Cancer Research UK and others have long argued that the current threshold (currently set at £30,000) is too low for small patient groups, such as people with rare cancers. This has meant patients have been denied access to treatments on the NHS that would extend and improve their lives.
Today the Government announced that they’ll be raising this threshold for drugs which treat people at the end of their lives and which are suitable for treating small numbers of people, for example people with rarer cancers. This will mean many new drugs will be approved to treat rarer cancers.
This is fantastic news.
The Government will adopt new, flexible pricing systems for more cancer drugs
Alongside increasing the NICE threshold for certain types of drugs, importantly the Government has also announced that it will take action to reduce the costs of some of these new medicines, at least initially. It will allow the pharmaceutical industry to adopt more flexible pricing for new medicines.
For example, a company would agree to price a new drug low to begin with, but, as it begins to be delivered on the NHS and used to treat more and more patients, and evidence of its effectiveness increased, the company would be allowed to increase the price.
Measures such as this should help reduce the overall cost of new drugs and make sure that patients have access to new drugs quickly.
The Government will not withdraw NHS treatment from people who opt to pay for ‘unapproved’ drugs
The issue of ‘top up fees’ or co-payments has been a burning issue all year. The debate is simple – the Government has taken a stance that it will not allow patients to pay for treatments and yet still be treated by the NHS.
This is understandable, as there are genuine fears that this would allow a ‘two-tier’ health system where the wealthy get the best treatment.
Today the Government has reversed its stance and will allow patients to pay for treatments otherwise denied them by the NHS on cost grounds.
Now, we share concerns about a two-tier health system, but given the action being taken on the NICE process and on drug pricing outlined above, we believe that most patients will now get access to effective new drugs on the NHS, and the issue of ‘top-up’ treatments remains an issue for only a very much smaller number of people.
Where top-ups are still relevant, it will be extremely important that patients are given all the information they need to make the decision about whether they want to pay for their treatment.
The bottom line
Taken together, these new policies represent a substantial piece of good news for patients and their families. We have long argued that, despite the great work the NHS and NICE does, there remain errors and inconsistencies in the way access to new drugs is regulated in the UK.
Today’s announcements should go a long way to correcting these problems.
What we now need to ensure is that the changes are delivered in a timely and effective manner – every further day of delay is a day when people aren’t getting the treatments they need.
And we should also remember that drugs are not the whole story. The UK Government needs to address other issues with access to care, such as diagnostics and radiotherapy.
Today is a giant, significant step forward in the still longer journey towards beating cancer.
- read the report by Professor Mike Richards, National Cancer Director, that led to the Government announcement
- Cancer Research UK’s policy position on cancer services and treatments
Henry Scowcroft November 26, 2008
Thanks for all your comments – and in case you missed it, last week the Government announced a new deal with the pharmaceutical industry which should lead to lower costs and greater access to treatments, which is great news.
Patricia November 11, 2008
It costs pharmaceutical companies many millions of pounds to develop and test new potential drugs, hence the costs to the public must be high. Extend the licence period for the company to have sole manufacturing rights and hence profits and in the long run the companies will put more effort into manufacturing the drugs and the costs to the public will eventually come down.
Susanne November 11, 2008
There will never be enough money to do all the things that need doing, just as there will never be enough time. Any organisation, be it publicly funded or otherwise, knows that the people it exists for, it’s patients, relatives of patients, employees, volunteers, are extremely grateful for any additional assitance with care for cancer patients. Personally, I am aware of the fear of the two-tier system, but the benefit of lifting the ban on top-ups far outweighs the risks. There are many people who would, in desperation, pay for a “miracle” treatment offered in a foreign country over the internet. I have a close relative who has worked hard for many years in two countries. Before this decision he could have received the recommended treatment abroad, away from his family, or receive NHS treatment surrounded by his loved ones. Now he has an option to make a financial decision in the context of expert, consistent care, life expectancy and what is recommended by professionals the most appropriate treatment.
Beth November 11, 2008
As someone who has just been given an all clear after operations last year, I really do find it offensive that someone can refer to medical intervention as “false hope and miracles”. Money spent on medical progression and medicines designed to improve the outcome for the patient should not be dismissed in such a way.
Claire November 11, 2008
Entering into negotiations with organisations that make money on peoples ill health is negligent of the taxpayer without whom the NHS would not exsist. The possible cost inflates to billions as poor lifestyle and education on diet increases the incidence and impact of cancer. The finance should be used to fund valuable services that make a patients end of life experience comfortable. Do I really have to remind the public that most hospice care in this country is provided and funded by charitable foundations and not public money? These people help with accepting death and dying and promote comfortable and pain free environments in a patients home or within a hospice dedicated to good nursing care. They do not promote false hope and miracles.
joncancer November 5, 2008
Unfortunately prostate cancer symptoms are not seen in the early stages when it can be curable. Decrease in food intake, lack of hunger, weight loss, softening of bone are the symptoms seen in advanced stages.