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Why the cancer drugs fund is a mistake

By Nigel Praities

The Government wants to spend millions on cancer drugs, but patients with other diseases are equally in need of new medicines.

While it professes to be a supporter of evidence-based medicine, the new coalition Government is showing worrying early signs of pandering to popular opinion.

Take its recent announcement about homeopathy. In a response to a report from the House of Commons Science and Technology Committee, the Government used the mantra of ‘patient choice’ to paper over the lack of any confirmed benefit through randomised clinical trials for the treatments.

Secondly, the announcement yesterday of a £50 million fund for cancer treatments not approved by NICE.

While Andrew Lansley says it will not undermine NICE, it is clearly designed to give cancer drugs an easier ride.

The ‘clinically-led regional panels’ are only going to look at the same evidence as NICE appraisal panels, without the constraints of having to consider cost-effectiveness data.

As health economist Professor Alan Maynard – quoted in the Guardian today – says, it looks like a ‘victory for the lobbying power of pharmaceutical companies’ who often are the ones setting the premium price that means their cancer drug falls below cost-effectiveness threshold at NICE.

There is no doubt that the UK has become more heavy-handed with pharmaceutical companies in order to keep the prescribing bill under control, but the report from Professor Mike Richards on access to medicines in the UK – cited by Mr Lansley as showing a ‘scandalous’ level of access to specialist cancer medicines – is a bit more equivocal when you read it in detail.

High levels of medicine usage do not always equate to better care, the report points out. The UK has a remarkably low level of antipsychotic drug use according to Professor Richards’ report – surely that must be a good thing.

It also may be a marker of a health system that is bad at preventing, rather than treating disease. Extra cash towards reducing waiting times for cancer diagnostics – such as ultrasound – could mean fewer drugs are used in the long-term.

The report also points out – although this was not covered with such glee in the newspapers this morning – that the UK has a low level of access to drugs for diseases such as osteoporosis and multiple sclerosis. Why are these conditions excluded from the new £50m fund?

There can only be one answer – political expediency over evidence.

By Nigel Praities is deputy editor of PulseToday

By Nigel Praities