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Cancer patients in life-saving drugs lottery

Many NHS patients are missing out
Many NHS patients are missing out - iStockphoto

NHS patients are missing out on life-saving drugs because of restrictions on who is allowed to benefit from them.

Britons face more “access barriers” to new medicines than people in France, Germany and the USA, a damning new report by the Pharmaceutical Research and Manufacturers of America (PhRMA) has found.

Cancer drugs in particular have “seriously restricted access” by the NHS watchdog, it said.

More than twice as many cancer patients in Germany and France are able to access cutting-edge treatments than in Britain.

For every 17,000 people in the UK taking a newly approved cancer drug, there were 36,000 in France, 39,000 in Germany and 234,000 in the USA, the analysis found, which included an adjustment to account for different population sizes.

The Government’s Office for Life Sciences own analysis backs up the claims, revealing that just two thirds of the 168 medicines approved for use in Europe between 2018 and 2021 were approved in England, down from 72 per cent in the previous three years..

The PhRMA report assessed all new drugs between 2017 and 2022, and revealed that the National Institute for Health and Care Excellence (Nice) approved just 13 per cent without restrictions. A further 26 per cent were approved with eligibility criteria that limited the number of patients who could benefit.

It means two thirds of drugs licensed for NHS use had limits on who could access them, such as requiring patients to have tried other treatments first without success or have an illness or disease that has progressed and become more serious.

While France also approved 39 per cent of new drugs, 23 per cent had no restrictions.

Germany approved 62 per cent of the drugs, 61 per cent without any access restrictions, while the USA gave the green light to 85 per cent, of which just 0.5 per cent had restrictions.

David Watson, director of patient access at the Association of the British Pharmaceutical Industry, said: “The Government’s own data also shows that some patients here are missing out on new medicines available in other countries.

Women with incurable cancer could get two extra years

“The solutions to this lie in having flexibility in how new medicines are valued in the UK, and having all parts of the NHS follow Nice guidelines. We continue to work with Nice to help more people get the medicines they need.”

The watchdog, Nice, assesses the cost effectiveness of treatments and decides if they represent good value for money to the taxpayer before agreeing they can be used to treat NHS patients.

Less than three months ago, Nice rejected the life-extending drug Enhertu (trastuzumab deruxtecan) for breast cancer patients, which is already available in the US and Europe.

It would have given about 1,000 women with incurable cancer up to two extra years of life, and could still be approved at a future date.

Last year Nice rejected extending the licence of an existing drug, Lynparza (olaparib), to men with advanced prostate cancer. It was approved seven months later, in April 2023, following a commercial arrangement between NHS England and the manufacturer, AstraZeneca.

Another drug for prostate cancer, abiraterone, is available as a first treatment option for men across Europe, including in Scotland and Wales, but not in England or Northern Ireland, despite being developed at The Institute of Cancer Research in London.

It was first available on the NHS for advanced forms of prostate cancer in 2012 but its access to most Brits remains limited.

Other patients have also been affected. Last month, Nice said life-saving cystic fibrosis drugs were no longer affordable in a provisional change to the guidance, having been available for children as young as six from 2020, as reported by The Telegraph.

Nice approach is  fairest and most robust in the world

Anyone already taking the drugs will be allowed to continue the treatment, while the Medicines and Healthcare products Regulatory Agency (MHRA) has also licensed the drugs, Kaftrio and Kalydeco, for children from the age of two.

A final decision is due this month.

A Nice spokesman said: “Nice’s approach to making recommendations for healthcare technologies is widely regarded as the fairest and most robust in the world.

“Only a small number of drugs receive a negative recommendation. Our approach allows us to focus on the topics that have the biggest impact on improving health and care outcomes and allows us to offer flexibility when appraising drugs which treat severe conditions.

“In other countries there are often local decisions by payers or specific hospitals about which medicines will be reimbursed; in England, a decision by Nice means that the medicine is accompanied by a national funding mandate.

“Within Nice, we are continuing our focus on getting the best care to patients fast, while ensuring value for the taxpayer. We are doing so in partnership with our partners in government, the NHS, and in industry.”