Magazine article The Spectator

Death, Drugs and Red Tape

Magazine article The Spectator

Death, Drugs and Red Tape

Article excerpt

Over the next few weekends, the gardens of 23 stately homes will be opened up to several thousand sponsored fun-runners who, demonstrating the typically huge generosity shown towards cancer charities by the British public, will raise £2.5 million for oncology research. Elsewhere, the stalls at village shows will heave with home-baked cakes, thousands will empty their lofts to send surplus possessions to Cancer Research shops, and many more will be stuffing 'pinkie rings' on to their fingers and toes in order to support work on breast cancer. In all, Britons last year raised £302 million for cancer charities, far more than any other country in Europe.

As a result of their generosity, the British public can bask in the warmth of knowing they have helped to extend many lives.

Perhaps Brigitte from Malmo will send a thank-you letter, Jose from Bilbao a card, and little Anders in Zurich a drawing of a reindeer. They are all worthy recipients of our charity, of course. It is just a shame that British cancer-sufferers will have to wait another year or two to benefit from the same treatments which are already saving lives elsewhere in Europe.

The backwardness of cancer treatment in NHS hospitals was brought to light last week by the case of Barbara Clark, a Somerset nurse who won an appeal against the refusal by Somerset Coast Primary Care Trust to treat her with Herceptin.

Although the drug has been found to extend the lives of women with advanced breast cancer by 50 per cent, the trust had declined to prescribe it on the grounds that it is not licensed for use within the NHS.

Yet it is five years since Herceptin received a licence from the EU's Committee for Medicinal Products for Human Use, a body set up to provide a single system of safety regulation for all drugs used in the EU. The problem is that in Britain all new drugs must undergo an additional cost-benefit analysis before they are allowed to be used within the NHS. In England this is undertaken by the National Institute for Clinical Excellence (Nice), while -- as if to ensure the maximum job creation for public servants -- Scotland and Wales have their own equivalents. The manufacturers of Herceptin, Roche, have yet to apply for a licence for Herceptin from Nice, saying they won't have enough data to satisfy the institute until next February. At the very earliest it will be well into 2007 before English doctors are free to prescribe Herceptin for patients other than Miss Clark. Ironically, the government set up Nice in 1999 with the intention of ending 'postcode prescription' and thus to iron out what Labour ministers like to call 'health inequalities'. The unfortunate result is that whereas under the old system -- where the decision whether or not to use certain drugs was left to individual hospitals -- patients suffered if they had the wrong postcode, now patients are suffering nationwide.

It isn't just Herceptin. The charity CancerBACUP recently published a list of 23 drugs which it says are being unnecessarily denied to British patients. Among them are Bevacizumab, found to extend the lives of bowel cancer patients, which was licensed by the EU in January 2005 but will not be available in Britain until November 2006 at the earliest; and Bortezomib, found to extend the lives of myeloma patients by an average of 18 months, which was licensed by the EU in May 2004 but will not be approved by Nice until at least 2007.

A similar point is made by researchers at the Karolinska Institute in Sweden, who last week published a study into the availability of various cancer treatments across Europe. It concluded that British, Norwegian, Polish, Hungarian and Czech cancer patients were all at a disadvantage when it comes to gaining access to the latest drugs. The prime reason in Britain, said the researchers, was the sclerotic bureaucracy of Nice. As a measure of the inefficiency of Nice, take the case of Arimidex and Docetaxel, both breast cancer drugs, the latter of which has been found to reduce by 30 per cent the risk of patients suffering a relapse after surgery. …

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