British cancer patients will have to cough up £60,000 of their own money to access the latest raft of tyrosine kinase inhibitor treatments, a leading
doctor has warned.
At least half a dozen breakthrough drugs due this year will prove too
expensive for the National Health Service, Karol Sikora of Imperial College London writes in the latest issue of the Journal of the Royal Society of Medicine.
“Over the next 12 months there will be at least six new, powerful targeted
anti-cancer drugs administered as simple tablets for breast, lung, kidney and colorectal cancer,” he said. “These drugs inhibit tyrosine kinases, a key signalling system in cells, and will cost at least £60,000 per patient per year. It is unlikely the NHS will be able to afford any of them and in any case the National Institute for Health and Clinical Excellence's backlog will delay their assessment for at least a year.” He claimed that Roche’s Avastin (bevacizumab) and Tarceva (erlotinib), GlaxoSmithKline’s Tykerb and ImClone’s Erbitux (cetuximab) would be some of the drugs under the spotlight.
Controversially, Prof Sikora said that to help them get the treatments, NHS patients should be allowed to “top-up” their care in the private sector. "Topping up" would at least allow patients to retain some free NHS care,
such as scans, radiotherapy and other drugs. At the moment, patients can only get private care if they pay for all their treatments in the private sector.
A spokewoman for the influential charity Cancer Research UK was hesitant
about the proposals. “All thoughtful ideas should be considered,” she said.
“Prof Sikora's idea is one such. However, it potentially throws up its own
difficulties and would need to be discussed in considerable detail before
being championed." Ian Beaumont, chief executive of Colon Cancer Concern, gave a terser and more populist response, however. “We believe that if a patient is told by his consultant that he can benefit from a drug, then he should get it free on the NHS,” he said.
However, Prof Sikora said that the spiralling costs of new cancer treatments
meant the UK needed an urgent political debate about how it would be paid
for. “Despite the £90 billion being spent in the NHS in 2007, which will rise
to an expected £108 billion next year, UK service provision and technology still lagged behind its European neighbours,” he noted, adding that the UK was particularly weak in providing the latest “precision radiotherapy” services that were routinely available on the Continent.
“How much we are willing to pay for an extra year of good quality life with
cancer is going to be a key question for the baby boomer generation," he
concluded. By Michael Day