Patients are ‘missing out on cancer drugs’

Professor David Cameron, who is Professor of Oncology at Edinburgh University and director of NHS Cancer Services at NHS Lothian, said figures appeared to show fewer patients here were receiving expensive life-extending drugs than elsewhere in the country.

Many such drugs are available in other parts of the UK and Europe but are not routinely offered to patients in Scotland on the NHS. Patients instead have to apply for drugs not approved for widespread use by the Scottish Medicines Consortium on a case-by-case basis by submitting an Individual Patient Treatment Request (IPTR).

But figures revealed to the Scottish Government’s health and sport committee show that just 17 such requests were made in Lothian in 2011/12 – of more than 350 submitted throughout Scotland.

Despite NHS Lothian being the second largest of Scotland’s 14 health boards, it ranked eighth in the number of IPTRs submitted, with far smaller NHS services in Dumfries and Galloway, Forth Valley, Ayrshire and Arran and Dumfries and Galloway all processing and granting more requests.

Prof Cameron, who gave written evidence to Holyrood’s health committee this week on the issue of access to  new cancer drugs, said:  “Anecdotally, we have heard the IPTRs are used differently by different health boards. These statistics are consistent with different expectations of what will be approved, depending on the part of the country.

“They support the view that clinicians are unlikely to submit requests unless there’s a high chance of approval. If they are being used differently, it’s undermining equality of access.

“It’s fair to ask the question of whether the current system means patients are getting drugs in other parts of the country which in Lothian they wouldn’t. The rate would suggest that there is low access for Lothian patients.”

He added: “This isn’t a criticism of NHS Lothian – but it’s an observation on inequality of access to drugs caused by different applications of the IPTR process. It’s something that these patients need an answer to and the Scottish Parliament needs to address it.”

Although the rate of requests which were successful in Lothian was relatively high – with 13 of the 17 accepted – 58 were accepted by the health board in Glasgow, 35 in Tayside, 32 in Fife and 22 in Ayrshire and Arran.

Tory health spokesman and deputy leader Jackson Carlaw MSP said: “It is completely unacceptable that someone living in one part of the country is more likely to receive life-extending medicine than those elsewhere. It’s a postcode lottery with people’s lives.”

Dr Tracey Gillies, NHS Lothian’s divisional medical director, said: “There is a process in place to deal with IPTRs, which is defined by the Scottish Government and is followed by all health boards. NHS Lothian operates within these terms and clinicians make applications in accordance with the best interests of their patients within the guidance.”

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