Gimee,Gimee,Gimee, the continual whine of women!

http://news.independent.co.uk/uk/health_medical/article355173.ece

Cancer: There are life-saving drugs. So why can't we have them?
By Sophie Goodchild, Chief Reporter
Published: 02 April 2006
Thousands of cancer sufferers are being denied life-saving drugs because of
delays and bureaucracy in making them available on the NHS.

The hold-ups are a matter of life and death for desperate people who have been
diagnosed with cancer of the breast, colon or lung, or with a brain tumour.

Last week, a patient who was refused the drug Herceptin for her breast cancer
launched a High Court challenge to the decision. But The Independent on Sunday
has established that an "exciting" new range of drugs which work in a similar
way is also being denied to patients.

Doctors are furious that drugs such as Avastin, which is used to treat colon
cancer, and Cetuximab, a treatment for head and neck cancers, are being blocked
by the National Institute for Clinical Excellence (Nice), a government-appointed
quango set up to decide which drugs should be routinely prescribed on the NHS.

But backlogs mean that Nice is taking up to two years to make its decisions.
That means drugs such as Avastin, which have been officially licensed and
approved for use, are currently denied to NHS patients although well-off people
can obtain them privately. In some cases, patients are being told they face a
three-year wait if they want to obtain these life-saving treatments free.

Cancer charities, MPs and leading specialists are warning that this is creating
a two-tier system where only those with money, and the well-informed, can afford
the drugs, which cost many thousands of pounds.

They also condemn the postcode lottery over prescribing of cancer drugs, which
means that some people are turned down for treatment but others are successful
in proving that their case is "exceptional", depending on what part of the
country they live in.

Senior Labour and Liberal Democrat MPs last night called jointly for a radical
overhaul of how trusts provide treatment, with the public having a say in the
decision on how cash is to be allocated.

A prominent committee of MPs is also demanding that the Government ring-fence
money for cancer treatment and that specialist networks, not NHS trusts, should
be set up to decide where the cash is spent.

The All Party Group on Cancer, which last week published a damning report
revealing the huge inequalities in provision of cancer drugs, wants decisions to
be fast-tracked by Nice.

"It's now becoming a case of life or death for cancer patients," said Ian
Gibson, the group's chair. "People are not getting the drugs they need and it's
not acceptable to have one region where people survive and others who do not."

Nice acknowledged there was a backlog but said there was no reason for trusts to
withhold treatment using drugs that had not yet been approved. A spokes-woman
also said that Nice had speeded up the system so that cancer drugs would by
approved by the panel "within weeks" of being licensed.

"It's not acceptable for trusts to use Nice as an excuse not to prescribe," she
added. "It's true that there is a backlog, but we believe our process is
thorough. Our new process will ensure that newly licensed drugs are approved
within a matter of weeks

Professor Steve Webb, the Liberal Democrat spokesman on health, said that the
prescribing lottery was "unacceptable" and called for patients to be consulted
over how NHS trusts spend their surplus cash. "These arbitrary variations based
on postcodes are unacceptable," said the MP for Northavon.

"Each year the PCTs (Primary Care Trusts) should consult the public about how
they want the money to be used. Local people should have more say."

Leading cancer specialists also point out that Britain is lagging behind much of
Europe in the availability of the newest generations of cancer drugs. They are
calling for the gap between the licensing of drugs and Nice approval to be
closed as a matter of urgency.

One of Britain's leading oncologists, Professor Jonathan Waxman of Hammersmith
Hospital in London, said that trusts were also guilty of "outrageous arrogance"
in how they decided who received life-saving treatment and who was turned down,
especially as they are dealing with people for whom even a day's delay is a blow
to their chances of survival.

"Why should cancer in Tottenham be different from cancer in Totnes? There should
be a fair, central process," said Professor Waxman, who has written to Patricia
Hewitt, the Secretary of State for Health, outlining his concerns over how NHS
trusts operate.

"It's outrageous arrogance that trusts say it's not appropriate to provide drugs
to certain people."

The charity Cancerbacup, which provides advice for patients, backed demands for
specialist cancer networks to replace the current system where hundreds of
funders try to manage small pots of money.

"Access to new cancer treatments depends on where you live or failing that how
much money you have," said Joanne Rule, the charity's chief executive.

"Consultants tell us that they are treating their private patients with drugs
they can't use in the NHS. The process for making new treatments available on
the NHS needs to be speeded up."

THE DRUGS

AVASTIN (BEVACIZUMAB)

Effective treatment for colon cancer that can shrink tumours by 40 per cent. Yet
to be approved for general NHS use. Cost for 24 treatments: £20,000

HERCEPTIN (TRASTUZUMAB)

Breast cancer drug that uses natural immune system to kill cancer cells. Costs
£20,000 a year. Currently denied by NHS to women in early stages.

CETUXIMAB (ERBITUX)

Stops cancer cells growing and increases effectiveness of chemotherapy.
Available on NHS only in exceptional circumstances. Twelve doses: £7,000



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