Key quote: "The NHS is saying to [patients], 'Tough luck, there's nothing we can give you'. But that is not the case. If you lived in North America you would get these drugs, but not in Scotland." - Dr Paul Nathan, consultant oncologist
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PATIENTS with advanced kidney cancer in Scotland are to be denied a drug which could prolong their lives.
The Scottish Medicines Consortium (SMC) yesterday refused to recommend Sutent for use on the NHS, meaning patients who fail on current treatment will have no other drug options.
The decision was criticised by doctors and charities, which said around 300 patients a year in Scotland would benefit from the treatment.
But others said such decisions were necessary in an NHS with limited resources.
Sutent works by stopping the signals in the body that tell cancer cells to grow and multiply. The drug also stops blood vessels growing into the tumour.
The manufacturer, Pfizer, applied for the drug to be approved for use in patients who failed to respond to interferon-alpha.
But the SMC ruled that "the economic case has not been demonstrated".
The drug costs around 2,000 a month, compared to 700-800 for interferon.
Pat Hanlon, from Kidney Cancer UK, said:
"We know the NHS has limited resources, but for patients with kidney cancer there are not many other treatments they can try.
"When they stop responding to interferon, there is nothing else for them."
Paul Nathan, a consultant medical oncologist, said data showed that Sutent doubled the length of time before kidney cancers started growing again.
Dr Nathan said, while it was not a cure, it could extend patients' lives by eight months or more.
A consultant oncologist working in the NHS in Scotland, who asked not to be named, said he understood that the NHS had a limited pot of resources.
"But for my patients, if you are diagnosed with advanced kidney cancer your chances of responding to current treatment are minimal - four out of five will get no benefit," he said.
"Then the NHS is saying to them, 'Tough luck, there's nothing we can give you'.
"But that is not the case. If you lived in North America you would get these drugs, but not in Scotland."
The issue of NHS resources and drugs rationing is set to be discussed tonight in a debate organised by The Policy Institute.
One of the speakers, Dr Andrew Walker, health economics expert at Glasgow University, said organisations such as the SMC were necessary to make treatments fairer, no matter where you live.
But he said that, for individual patients, the decisions could be tough.
"What the SMC has to do is to look at what is good for the population generally, rather than for individual patients.
"If you spend the money in one place you can't spend it elsewhere," he said.
But the economist will also talk about the need to scrutinise other areas of health policy to make sure they represent value for money.
Dr Walker asked: "If you subjected government policy to the same level of scrutiny to which we subject new treatments, would there be some spending areas which could free up resources for use elsewhere, including the drugs bill?"
Dr Anna Gregor, clinical director of the South East Scotland Cancer Network, who will also speak at the debate, added: "There will never be enough money for everything we want in a cash-limited system. There will always be choices.
"What is important is that there is openness in how these decisions are made. In Scotland we have the Scottish Medicines Consortium. This has helped mean that what we are providing is provided consistently."
NEW MEDICINES THAT WON FAVOUR
PATIENTS suffering from rare types of anaemia will benefit from a new drug which has been approved for use on the NHS in Scotland.
The Scottish Medicines Consortium (SMC) recommended Exjade for patients with chronic iron overload linked to treatment for anaemia, which means they have to undergo repeated blood transfusions.
The SMC also accepted the drug Prograf to stop rejection in heart patients who have had a transplant of tissue, cells or a whole organ.
And the drugs body has approved the use of Tachosil - a type of medicated sponge used in surgery. The sponge is used to stop bleeding where other techniques used by doctors have failed.
OBESITY DRUG TURNED DOWN
THE anti-obesity drug Acomplia has been rejected for use on the NHS.
The drug, which costs about 55 for a 28-day treatment, was licensed last summer as the first drug to target factors governing appetite, metabolism and energy use.
Trials have shown that it can reduce weight by a tenth. But the Scottish Medicines Consortium said the economic case had not been demonstrated.
Sanofi-aventis, which makes the drug, said it now plans to submit more evidence to the SMC.
The SMC also rejected the drug Alimta, for non-small cell lung cancer.
It works by blocking enzymes thought to play a role in the rapid growth of these lung tumours.