The UK ranks eighth out of 14 nations in terms of its usage of innovative medicines, and plummets to 12th place when assessed on its uptake of cancer drug treatments introduced within the last five years, with only Canada and New Zealand doing worse, says a new report.

The UK is also second from bottom in terms of use of drugs to treat hepatitis B and multiple sclerosis study, according to the long-awaited study, by England’s National Cancer Director, Professor Sir Mike Richards, which was published yesterday. However, the report also shows that the nation is in second place, behind Australia, for the use of statins to reduce cardiovascular disease, and second again (after Denmark) for usage of thrombolytics to treat acute myocardial infarction (MI).

Based on data from IMS Health, Sir Mike’s study examined usage of 123 drugs in 14 countries across a range of therapy areas during April 2008-March 2009. 66 of the products are cancer treatments, and the study breaks the 14 nations’ uptake of these products down further - into cancer drugs which have been on the market for up to five years, those which have been available for six to 10 years, treatments launched more than 10 years ago and cancer hormones.

Unsurprisingly, the USA ranks as overall leader of the 14 nations in terms of medicines uptake across all therapy areas, and individually in its use of antipsychotics and drugs to treat dementia, respiratory distress syndrome (RDS) and rheumatoid arthritis (RA). However, the USA is also in 13th place not only for use of acute MI drugs but also for cancer hormones, for which only New Zealand has a worse record of use.

It is also probably not surprising that New Zealand takes the bottom ranking both overall and individually for its uptake of drugs to treat dementia, multiple sclerosis, osteoporosis, RA, wet age-related macular degeneration (AMD) and in all the cancer categories.

The second-highest level of usage overall was reported for Spain, followed by France, Denmark, Australia, Switzerland, Canada, the UK in eighth place, then Austria, Norway, Germany and Italy in joint 11th position, Sweden 13th and finally New Zealand.

However, in common with most countries, the UK’s ranking across disease areas and drug categories is not consistent. It scores: relatively highly (rank 1-4) for the use of thrombolytics for acute MI, surfactants for RDS and statins; at intermediate level (rank 5-9) for cancer hormones, cancer drugs launched between six and 10 years ago, osteoporosis, respiratory syncytial virus (RSV) prophylaxis, stroke and wet AMD; and relatively low (rank 10-14) in uptake of cancer drugs launched within the last five years and also for its use of cancer treatments which were introduced over 10 years ago, plus use of dementia, hepatitis C, multiple sclerosis and RA drug treatments and second-generation antipsychotics.

The study reveals that nations which spend the most on health do not always have the highest levels of drug usage, while lower spenders can be high users of drugs, Sir Mike said yesterday. He also emphasised that his study makes no judgement as to whether high or low use of a drug could be considered to represent good clinical practice, nor does it seek to identify a correct level of utilisation.

Sir Mike also warned against taking a “simplistic” view of the report’s findings and how they relate to life expectancy and survival rates, pointing out that for cancer, the most vital issue is early diagnosis and that most drug treatments are about extending life for a few months.

“I honestly don’t think that drug usage is linked to survival,” he told journalists yesterday.

However, he added that a number of common themes, often working in combination, have been identified as appearing to influence levels of drug usage in the UK compared with other nations. They are: the impact of Health Technology Assessment (HTA) processes; the effectiveness of service planning, organization and direction setting; and clinical culture. These factors are “worthy of further exploration,” said Sir Mike.

He also urged “all those with a stake in improving services in the disease areas” that are examined in his report “to assess the findings and consider whether the levels of usage observed in the UK are appropriate.”