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Doctors in the UK fear the NHS will be unable to afford new-generation cancer drugs coming onto the market.
Respondingto a British Broadcasting Corporation questionnaire, 180 oncologistssaid they were worried or very worried by the situation whereby manydrugs were not being funded by the NHS because they failed to meetcost-effective criteria set out by the National Institute for Healthand Clinical Excellence (NICE).
There is also concernthat patients may have to pay for more drugs themselves, and some ofthose who offer to do so are being told they would have to meet alltheir care costs, due to different interpretations of contracts andpolicies designed to separate private from NHS-funded care.
Abouthalf the drugs submitted to NICE are for cancer and have had mixedfortunes. Roche/Genentech’s Herceptin® (trastuzumab) got the greenlight after much heated debate, but Tarceva® (erlotnib) from OSIPharmaceuticals and Roche was rejected. The latest reversal forImClone, Bristol-Myers Squibb and Merck KGaA’s Erbitux® (cetuximab)came on 14 May as NICE rejected it as not cost-effective in treatinghead and neck cancer, a decision Merck is expected to appeal against.
ProfessorNick James, head of clinical oncology at Birmingham University, toldthe BBC the gap between what the NHS could pay for and what wasactually available would get bigger. “The drugs in the pipeline aregoing to cause even more pressure. Politicians need to be honest andsay this gap is going to be there and we need to look at ways offilling it.” He believes it is inevitable that patients will have tomake a bigger contribution to treatments themselves, but fears NHSpolicy stands in the way.
The BBC poll came out as areport was released by national cancer director for England ProfessorMike Richards. He said the NHS must continue to change if it was todeliver better care to patients, and while the system had improved,more reform was necessary. Professor Richards claimed treatment andcare needed to be concentrated in specialist centres “so clinicianswith the right skills, experience and equipment are available to treatpatients with complex needs safely”.
He said medicaltechnology was also making it possible to treat many patients closer tohome, and insisted the needs of patients should be placed ahead of theconvenience of the NHS.
Cancer Research UK welcomed theway the Government sought to tackle the problem, but medical directorDr John Toy said: “We must not rest on our laurels if we are to meettoday’s and the future challenges of cancer and more closely match theUS and Europe in terms of cancer survival.”