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'Let patients top up NHS treatment or risk black market in cancer drugs'
Anna Davis11.09.08
A black market in cancer drugs could be created if the Government fails to allow patients to "top up" their NHS treatment, health experts warned today.
It adds to increasing pressure on ministers to allow patients to spend their own cash on drugs not funded by the health service.
The country's leading cancer specialists were meeting in London today to discuss whether patients should be allowed to pay extra for medication not deemed cost effective by health watchdog Nice.
It is part of an urgent government review of how it deals with patients who pay privately for extra drugs. Currently patients who do so are forced to pay for the NHS care they would otherwise have received for free, making it impossible for all but the richest patients to afford.
Karol Sikora, professor of cancer medicine at Imperial College, urged the Government to relax the rules. He said: "We have to allow them. We can't take people's care away because they choose to do something extra. We have to get more money into healthcare and it is unlikely that it will come from tax only. If we try to make it illegal, people will just do it secretly and not tell their doctors. There will be a black market in cancer drugs. The Government will have to liberate this. The hardline ideology just won't stand up."
Andrew Dillon, chief executive of Nice, is set to speak in the debate, as well as Professor Martin Gore, medical director of the Royal Marsden NHS foundation trust.
Professor Mike Richards, national clinical director for cancer, who is conducting the review, will speak, as well as Jo Webber, deputy policy director of NHS Confederation, which represents Britain's hospital trusts.
In the NHS Confederation's official response to the review, it said most of its members oppose top-up treatments because of the injustice to those who cannot afford them, but realise this is "almost certainly not sustainable".
The meeting follows a number of high profile cases where terminally ill patients have been denied life-extending drugs. Yesterday, a cancer patient with months to live won a High Court battle for a life-prolonging drug.
Colin Ross, 55, mounted a legal challenge to his NHS Trust's refusal to fund treatment. Judge Simon Grenfell overturned West Sussex PCT's decision that the new drug Revlimid would not be cost-effective.
Mr Ross, from Horsham, West Sussex, was diagnosed with multiple myeloma, an incurable cancer of the blood cells, in May 2004. If he had been living in neighbouring East Sussex he said he would have received the drug.
Q&A
What are top-up payments?
Also known as co-payments, the term refers to patients paying privately for extra treatment on top of normal NHS care. They are often associated with cancer sufferers paying for life-extending drugs not available on the NHS.
Why are they proving controversial?
Some patients have been denied NHS care when they have topped up their treatment privately. But a "postcode lottery" exists where some local health chiefs pay for some drugs that are denied by others. However, copayments exist in dentistry, where it is common for patients to pay privately for their teeth to be cleaned, while getting fillings on the NHS.
What is the current situation?
Patients who pay extra for drugs not funded by the NHS could be forced to pay for the NHS care they would otherwise have received for free. The Government has ordered a review of the situation.
What is the role of Nice?
The National Institute for Clinical Effectiveness decides what drugs should be available on the NHS by looking at their cost effectiveness. It looks at how much benefit the treatment gives, how long the benefit will last for, and how much it costs.
Reader views (3)
Rayb,when you say NHS did you mean to type IHS,International Health Service.
- Colin, Bristol
The only cure for this is for the Government to admit that it holds funds of insurance on behalf of the National Insurance, insured public. Then like any honest Insurance company issue a policy to the paid up members. In order to include cancer and other first rate treatments increase the premium. End of post code lottery!
Then the Government can decide on provision of funds for the huge number of EU members and other immigrants. If they are really so good for our country, the Government will not mind making provision that does not take from public insurance premiums.
That way, government can keep their hands off hard earned savings and we get a fair deal.
- Maria, London
There's little wrong with the idea of people using their own money to buy additional treatment, as long as it is done in agreement with their consultant. I'd hate to think about people having to sneak around without their consultant knowing, they could be damaging themselves, buy medication that has an adverse reaction to medication they are already taking. Desperate people do desperate things, and that's perfectly understandable. I only wish we had good price negotiators within the NHS to get some of the drug prices down. I would say it would be better if patients could order additional medication through the hospital pharmacy with the consent of their consultant. It may even be a little cheaper that way.
- Rayb, Newcastle upon Tyne, UK
