Post by jljenkyns on Nov 4, 2008 17:58:16 GMT 1
Terminally ill patients to get expensive new drugs on NHS
Terminally ill patients will be given expensive new drugs after the NHS rationing body was today ordered to place more value on the last precious months of life.
By Rebecca Smith, Medical Editor and Andrew Porter, Political Editor
Last Updated: 12:18PM GMT 04 Nov 2008
The NHS drugs rationing body the National Institute of health and Clinical Excellence (NICE) will be more flexible in deciding whether drugs for patients at the end of their lives are cost effective.
The move is a victory for campaigners who have argued that it is cruel to deny patients a drug that may extend their lives long enough to see a grandchild born, a daughter's wedding or the last Christmas with their family.
Currently expensive drugs that prolong life by a few months often breach the cost effective threshold used by Nice.
Some patients want to "top up" their care by paying for these drugs privately only then to be told they forfeit all of their NHS care and must pay for the entirety of their treatment. This is often more than they can afford.
In a fundamental shift in the health service, ministers will announce that patients will now be allowed to buy drugs privately without giving up the right to having the rest of their care paid for by the NHS.
A Whitehall source said: "NHS patients will be allowed to buy drugs not available on NHS as long as such treatment is entirely separate and we will take steps to enable the NHS to widen the range of drugs for terminally ill patients."
Ministers will admit there will be no financial help for poorer patients who cannot afford to top-up their NHS care.
Critics have said allowing top-ups will create a two-tier NHS and undermine the founding principles that care should be provided irrespective of ability to pay.
Patients wishing to top-up their care will have to be classed as a private patient and may be treated in a private hospital, the private ward of an NHS hospital or in their own home but it cannot be ruled out that they will be treated next to wholly NHS patients on the same ward.
It paves the way for thousands of patients with a whole range of conditions, including infertility, to top-up their NHS care with privately funded drugs or treatments.
The Government also wants to see more flexible pricing of drugs with the manufacturer receiving a lower price when the medicine is launched and when the treatment is proven effective, the cost to the NHS can increase.
Ministers will try to tackle the postcode lottery in drug funding decisions made by primary care trust exceptional case committees in the absence of Nice guidance.
There are currently 152 such committees around the country which often come to different decisions and have forced some patients to take legal action.
Fewer, larger committees will make these decisions in the future.
The changes have made following a review of access to drugs by Prof Mike Richards, the National Director for Cancer Services, ordered by Alan Johnson, the Health Secretary, in the summer.
Niall thingyson, chief executive of independent think thank, The King's Fund, said: "The current situation is simply untenable. Policy should be changed so that, in certain circumstances, patients will not lose their right to access the rest of their care on the NHS if they pay privately for drugs that have been rejected on cost-effective grounds.
"There are areas of the NHS where there is already inconsistency over patient charging, such as eye and dental care, and current rules don't make it clear to patients why these top-ups are allowed but others, such as the use of non-NICE approved drugs, are not."
Nigel Edwards, director of policy at the NHS Confederation, which represents 90 per cent of health service organisations, said top-up payments should not be allowed to undermine the core principles of the health service.
"Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge – no one wants a two speed health service.
"One of the concerns is that many of the drugs people want to top-up with are very expensive, and may only have limited effectiveness, the danger is of giving patients false hope of a cure.
"Now we have allowed top-ups we need to make sure patients get the best possible advice from their doctors and agencies like NICE about how effective additional drugs might be for them," he said.
Penny Wilson-Webb, chief executive of the Rarer Cancers Forum said: "To avoid 'top-ups', we need to get NICE working faster, we need to get exceptional cases panels working better, and we need to have fairer pricing of new drugs. The NHS should be there for all who need it, not to issue £20,000 bills to cancer patients for treatments which are recommended by their NHS doctor."
Andrew Lansley, Shadow Health Secretary, said: "Rather than attempting to address the more fundamental issue of why it is that the NHS is unable to provide cancer drugs to British patients that are routinely available across the rest of Europe, Labour have instead sought to reach a shabby short term fudge."
Norman Lamb, Liberal Democrat health spokesman, said: "The NHS cannot provide everything without regard to cost but that is not an excuse for the injustice and inhumanity of withdrawing all care from those that want to spend their own money on life-saving treatment.
"Any reform must not involve any extra cost to the NHS. It must not pave the way for queue-jumping in the NHS."
Terminally ill patients will be given expensive new drugs after the NHS rationing body was today ordered to place more value on the last precious months of life.
By Rebecca Smith, Medical Editor and Andrew Porter, Political Editor
Last Updated: 12:18PM GMT 04 Nov 2008
The NHS drugs rationing body the National Institute of health and Clinical Excellence (NICE) will be more flexible in deciding whether drugs for patients at the end of their lives are cost effective.
The move is a victory for campaigners who have argued that it is cruel to deny patients a drug that may extend their lives long enough to see a grandchild born, a daughter's wedding or the last Christmas with their family.
Currently expensive drugs that prolong life by a few months often breach the cost effective threshold used by Nice.
Some patients want to "top up" their care by paying for these drugs privately only then to be told they forfeit all of their NHS care and must pay for the entirety of their treatment. This is often more than they can afford.
In a fundamental shift in the health service, ministers will announce that patients will now be allowed to buy drugs privately without giving up the right to having the rest of their care paid for by the NHS.
A Whitehall source said: "NHS patients will be allowed to buy drugs not available on NHS as long as such treatment is entirely separate and we will take steps to enable the NHS to widen the range of drugs for terminally ill patients."
Ministers will admit there will be no financial help for poorer patients who cannot afford to top-up their NHS care.
Critics have said allowing top-ups will create a two-tier NHS and undermine the founding principles that care should be provided irrespective of ability to pay.
Patients wishing to top-up their care will have to be classed as a private patient and may be treated in a private hospital, the private ward of an NHS hospital or in their own home but it cannot be ruled out that they will be treated next to wholly NHS patients on the same ward.
It paves the way for thousands of patients with a whole range of conditions, including infertility, to top-up their NHS care with privately funded drugs or treatments.
The Government also wants to see more flexible pricing of drugs with the manufacturer receiving a lower price when the medicine is launched and when the treatment is proven effective, the cost to the NHS can increase.
Ministers will try to tackle the postcode lottery in drug funding decisions made by primary care trust exceptional case committees in the absence of Nice guidance.
There are currently 152 such committees around the country which often come to different decisions and have forced some patients to take legal action.
Fewer, larger committees will make these decisions in the future.
The changes have made following a review of access to drugs by Prof Mike Richards, the National Director for Cancer Services, ordered by Alan Johnson, the Health Secretary, in the summer.
Niall thingyson, chief executive of independent think thank, The King's Fund, said: "The current situation is simply untenable. Policy should be changed so that, in certain circumstances, patients will not lose their right to access the rest of their care on the NHS if they pay privately for drugs that have been rejected on cost-effective grounds.
"There are areas of the NHS where there is already inconsistency over patient charging, such as eye and dental care, and current rules don't make it clear to patients why these top-ups are allowed but others, such as the use of non-NICE approved drugs, are not."
Nigel Edwards, director of policy at the NHS Confederation, which represents 90 per cent of health service organisations, said top-up payments should not be allowed to undermine the core principles of the health service.
"Allowing private payments alongside NHS care cannot be allowed to become the thin end of the wedge – no one wants a two speed health service.
"One of the concerns is that many of the drugs people want to top-up with are very expensive, and may only have limited effectiveness, the danger is of giving patients false hope of a cure.
"Now we have allowed top-ups we need to make sure patients get the best possible advice from their doctors and agencies like NICE about how effective additional drugs might be for them," he said.
Penny Wilson-Webb, chief executive of the Rarer Cancers Forum said: "To avoid 'top-ups', we need to get NICE working faster, we need to get exceptional cases panels working better, and we need to have fairer pricing of new drugs. The NHS should be there for all who need it, not to issue £20,000 bills to cancer patients for treatments which are recommended by their NHS doctor."
Andrew Lansley, Shadow Health Secretary, said: "Rather than attempting to address the more fundamental issue of why it is that the NHS is unable to provide cancer drugs to British patients that are routinely available across the rest of Europe, Labour have instead sought to reach a shabby short term fudge."
Norman Lamb, Liberal Democrat health spokesman, said: "The NHS cannot provide everything without regard to cost but that is not an excuse for the injustice and inhumanity of withdrawing all care from those that want to spend their own money on life-saving treatment.
"Any reform must not involve any extra cost to the NHS. It must not pave the way for queue-jumping in the NHS."