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Report reveals UK access to new cancer drugs poor

NHS cancer patients are unable to access life-saving cancer drugs available to other patients in the US and the EU, according to a Roche-funded report

NHS cancer patients are unable to access life-saving cancer drugs available to other patients in the US and the EU, according to a Karolinska Institute report funded by Swiss pharmaceutical company, Roche.

The Swedish report accuses the NHS of "penny-pinching" and "excessive bureaucracy". It also shows that 67 new cancer drugs are on the EU market and that the UK is bottom of the list of countries with these drugs available as part of its healthcare system. Other countries named as having poor access to new cancer treatments were Poland, the Czech Republic, South Africa and New Zealand.

The report also revealed that research in the US has shown that new treatments significantly increase the chances of surviving cancer or extending life for incurable conditions, such as lung cancer. A separate study of 20 countries showed that nearly a third of the improvement in cancer survival rates between 1995 and 2003 were attributed to new treatments.

In the EU, the UK has the poorest survival rates and the lowest use of new drugs for cancers, compared with France, Spain, Germany and Italy. In all four countries, more than 50 per cent of cancer patients were treated with drugs launched since 1985, but in the UK the figure was only 40 per cent.

The report is an update of an earlier review published two years ago. Roche says it had no control of the report or its findings, but the conclusions will help the drugs industry highlight inequalities in access to cancer drugs and thus widen its marketing reach. The study looked at the availability of drugs over 10 years from 1995 to 2005.

The drugs, which cost up to GBP 100,000 (EUR 146,245) a year per patient, are putting pressure on health budgets in all countries. After decades in which little progress was made against cancer, new products are on the market providing patients and healthcare systems with stark choices.

Austria, France, Switzerland and the US top the league for the most widespread use of new cancer drugs. The bowel cancer drug Avastin (bevacizumab) and the lung cancer drug Tarceva (erlotinib) are used 10 times more frequently in the US than in the EU. Italy and the UK had among the lowest levels of use of Avastin, with the UK demonstrating the lowest use of Tarceva.

The report particularly criticises the UKís National Institute of Clinical Excellence (NICE), which it says "lacks the capacity to cope with its growing workload and criticises the Government for failing to reduce the delays. This leads to further delay for cancer patients in the UK getting access to new drug therapies and this is clearly demonstrated by the comparison of the UK with other countries studied in the report."

The Department of Health has defended NICE by saying "good progress" was being made in ensuring patients had access to cancer drugs and the appraisal processes within NICE had been accelerated.

A 2006 report by the cancer tsar, Mike Richards, showed use of new drugs in the UK had increased, with an NHS spokesperson saying that funding for treatments should not be withheld just because NICE guidance was unavailable.

NICEís CEO, Andrew Dillon, defended the instituteís record: "NICE has reviewed 39 cancer drugs for a variety of indications since its inception. Of these we have recommended 35 for routine or selective use, while only four treatments are not recommended for use in the NHS."

"The NHS has finite resources and it is our job to ensure that these are spent on treatments that confer enough of a benefit to patients in relation to the amount of money they cost," added Dillon.

Despite the negative findings of the report, survival rates for cancer victims in the UK have doubled over the past 30 years, according to figures released by charity, Cancer Research UK.

A patient had an average 46.2 per cent chance of surviving 10 years after diagnosis in 2001, compared with 23.6 per cent in 1971. The overall survival rate rose to 49.6 per cent, although risks vary with different types of cancer.

The figures also reveal a marked increase in survival rates over the past ten years, with the advent of newer cancer treatments. During this period, the combined 10-year survival rate for men and women rose from 35.4 per cent to 46.2 per cent.

Table 1: New cancer drugs status in UK

NICE approved

NICE rejected/awaiting appraisal

Name

Cancer

Approved

Name

Cancer

Status

Herceptin

Breast

 2006

Erbitux

Bowel

Refused approval in January 2007. Awaiting appraisal for head and neck cancer (expected June 2007)

Mabthera

Non-Hodgkin's lymphoma

 2004

Avastin

Bowel

Refused approval January 2007. Awaiting appraisal for lung cancer (expected January 2008), advanced breast cancer and advanced kidney cancer

Glivec

Chronic myeloid leukaemia

2003

Tarceva

Lung

Awaiting appraisal

Sutent

Kidney

Not referred for appraisal by Department of Health

Nexavar

Kidney

Awaiting referral by Department of Health for appraisal

Velcade

Multiple myeloma

Awaiting appraisal

Alimta

Mesothelioma and small-cell lung cancer

Patient groups are waiting for the results of an appeal for lung cancer. A mesothelioma ruling is expected in September 2007

16th May 2007

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