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Last updated at 06:07am on 04.06.07
Andrew Dillon: The only way
The makers of a cancer drug have offered to refund its cost to the Health Service if it fails to work.
The extraordinary offer by the manufacturers of Velcade has led to the lifting of an official ban on its use.
The U-turn will give new hope to some 20,000 Britons living with bone marrow cancer, also called multiple myeloma.
Velcade, also known as bortezomib, costs up to £18,000 per patient.
It extends life by an average of two to three years although it has given some sufferers an extra seven years.
Last year the National Institute for Health and Clinical Excellence, ruled it was not cost-effective, making it virtually impossible for it to be prescribed on the NHS in England.
The Government was immediately accused of "medical apartheid" because Velcade was available to NHS patients in Scotland, Wales and Northern Ireland.
Since then, cancer patients and charities have been fighting a fierce legal battle for the drug.
Now NICE is poised to agree a deal with its manufacturer, UKbased Janssen-Cilag. Under the proposed scheme every multiple myeloma patient would be given three months' treatment with the drug, during which time their reaction to it would be monitored.
If they react well - as 60 to 70 per cent of patients do - they would be able to continue with the treatment.
If there is no response, the company will refund the NHS the cost of their treatment.
The proposed deal could save the Health Service hundreds of thousands a year.
NICE said it was the first time the watchdog had recommended such a deal and it was the only way the drug could be made cost-effective for the NHS.
Chief executive Andrew Dillon said: "If the drug's manufacturer accepts the proposals we are consulting on today, it will mean that when the drug works well the NHS pays but when it doesn't the manufacturer should bear the cost.
"All patients suitable for treatment will get the chance to see if the drug works well for them."
Each year some 4,000 patients are diagnosed with multiple myeloma in the UK.
Fewer than a quarter survive for more than five years.
Last July's NICE ruling meant that any English patient who wanted the drug would have to pay the full price.
This led to some English cancer sufferers moving to live in Scotland solely to get the drug on prescription.
The cancer charities Myeloma UK, Cancerbackup and Leukaemia CARE launched a legal appeal against the decision.
They claimed that NICE's rejection of Velcade was based mainly on grounds of cost, rather than effectiveness.
They said its decision was "perverse and unfair".
At the Labour Party conference last September three terminally-ill cancer patients, calling themselves the Velcade Three, told Health Secretary Patricia Hewitt that NICE's decision had handed them a "death sentence".
One of them, Jacky Pickles, 45, said last night: "We are absolutely delighted with this positive decision.
"But we want to make sure there is no discrimination and that all sufferers get the treatment if they need it."
She praised Janssen-Cilag, saying: "They obviously feel strongly that their product is effective. They are prepared to put their money where their mouth is."
Harpal Kumar, chief executive of Cancer Research UK, said: "We commend NICE for recommending this innovative approach.
"Pharmaceutical companies with confidence in the treatments they are developing should not be frightened of schemes aimed at pricing them according to their benefit."
The Health Department and Janssen-Cilag have yet to agree to NICE's recommendation, although this is expected to happen later this year.
The company, based in High Wycombe, Buckinghamshire, is part of the Johnson & Johnson group.
