New warnings over UK cancer drug divide

The Rarer Cancer Foundation (RCF) has issued a warning that a “devastating” divide is opening up over access to cancer drugs between England, Scotland and Wales.

In a new report on the issue, the Foundation used the Freedom of Information Act to gather data from health trusts in England on the types of drugs approved through the government’s Cancer Drugs Fund, worth £200 million a year.

The research revealed:

• People in Scotland are three times less likely to get access to a newer cancer drug than people in England – if levels of access were the same, 248 more patients would benefit each year in Scotland;

• People in Wales are five times less likely to get access to a newer cancer drug than people in England – if levels of access were the same, 159 more patients would benefit each year in Wales;

• Comparable levels of access for people in Scotland and Wales could be delivered at a cost of only £1 per person in Scotland and Wales per year.

Chief executive of the RCF, Andrew Wilson, commented:

“The Cancer Drugs Fund is great news for people in England and has already benefitted thousands of patients. However, a devastating divide has opened up with Scotland and Wales.

“A cancer drug does not become any less effective simply because it is prescribed on the other side of a border. Nor does a patient’s need become any less pressing.

“The NHS should be there when you need it the most, regardless of where you live. People in Scotland and Wales will want to know why their chances of accessing a life extending cancer drug are so much lower than their neighbours in England.”

Explaining that the SNP administration would consider the report’s findings carefully, a Scottish government spokesman said:

“Scotland has robust, equitable and transparent arrangements for the introduction of newly licensed clinically and cost-effective medicines through the SMC and Healthcare Improvement Scotland, which operate independently from the Scottish government.

“These focus on equity of access to newly licensed drugs throughout Scotland, on the basis of their clinical and cost-effectiveness.

“These arrangements include flexibility for additional factors to be taken into account in prescribing decisions, such as opportunities for local clinically-led consideration of SMC ‘not recommended’ medicines for individual patients in certain circumstances.”

In Wales, the news of the divide comes just over a week after it was reported Lorraine Redmond from Cardiff, who is terminally ill with bowel cancer, was considering having to move to England to access Avastin, the drug licensed for the treatment of advanced colorectal cancer but which has not been approved for use on the NHS by NICE, the National Institute for Healthcare and Clinical Excellence.

Responding to the RCF report, the medical director of NHS Wales, Dr Chris Jones, said:

“We do not see a need for a separate cancer drug fund in Wales. We already spend approximately £5 more per head of population than England on cancer treatment. Even with the additional £200m available in England, it is still less than what we spend per head in Wales.

“There also appears to be no guarantee that all patients who request a given medicine will receive it even with the cancer fund.

“All new medicines deemed clinically and cost-effective by NICE or AWMSG are provided on the NHS. We have provided additional funding for the AWMSG to appraise more new medicines for use in Wales before NICE considers them and therefore these will be routinely available in Wales ahead of England.

“Where medicines are not approved, or are waiting approval, mechanisms are in place to ensure access for patients in exceptional circumstances.

“It is important to note these new medicines are often initially marketed with much promise and limited evidence of effectiveness and sadly do not save lives. Some of these medicines can also have significant side effects which can impact on quality of life.”