Emma Cowing: How come Megrahi can live, but Scots can’t?

EVERY YEAR in Britain, 37,000 men are diagnosed with prostate cancer. It is the second most common cause of death from cancer among men in the UK, after lung cancer, and accounts for 14 per cent of all male cancer deaths.

If you are a prostate cancer sufferer living in England or Wales, you may be able to gain access to a drug called abiraterone, which has been found to extend the lives of patients by an average of four months. Although the National Institute for Health and Clinical Excellence (Nice) has passed a draft decision ruling the drug too expensive, sufferers in England can still get it through a source known as the Cancer Drugs Fund, at least until a final decision is made by Nice. In Wales, the drug will be available no matter what the final Nice decision.

In Scotland, however, they will simply leave you to die.

This week’s ruling by the Scottish Medicines Consortium (SMC) that abiraterone would not be accepted for use on the NHS, because the “balance of costs and benefits meant the medicine was not considered to offer value for money”, essentially hands a death sentence down to hundreds of Scottish men in the final stages of prostate cancer. These are men without options, men who have been through chemotherapy and for whom there are no other treatments. Men at the end of the road.

The decision has caused uproar amongst cancer charities. Owen Sharp, chief executive of the Prostate Cancer Charity, remarked that the drug, “in very simple terms, allows men to spend precious extra time with family and loved ones. It is unjust that the SMC has made this decision – especially after a closed process that denies these men even the opportunity to have a voice or to appeal.”

Meanwhile, the Scottish Government is keeping well out of it, saying it accepted the recommendation of the SMC as an independent body and would not overrule it. This seems to me a curious stance from the same government that intervened to effectively prolong and improve the quality of life of another prostate cancer sufferer named Abdelbaset Ali Mohmed al-Megrahi.

It is believed that prostate cancer sufferer and convicted mass murderer Megrahi has been treated with abiraterone, possibly prescribed for him by the Tripoli Medical Centre, which has looked after the Lockerbie bomber since his return to Libya. Certainly, it seems to have worked for him. Megrahi was given three months. Two years later he is still alive, and has been able to spend much precious extra time with family and loved ones.

The decision has been made, of course, because of money. The drug, administered as a tablet, costs £3,000 for a month’s supply. Cancer Research UK, which helped fund initial research, has expressed its disappointment that Janssen, the drug’s manufacturer, has not lowered the price. Sadly, it’s doubtful it will.

Perhaps the most frustrating element of the SMC’s decision on this drug however is that it was – as the Prostate Cancer Charity pointed out – one that was made behind closed doors. In England, the Nice process of consultation allows for cancer sufferers, clinicians and charities to submit written testimonies, address and attend meetings and contribute to the decision- making process. The current Nice ruling is at a draft stage and more consultation will be made before a final ruling is given. In Scotland, apart from initial written testimonies, the entire decision-making process is made behind closed doors, and the final decision is exactly that. No appeals are allowed.

The Scottish Government described the SMC’s process as “transparent”, but many who fight the battle on prostate cancer’s front line would strongly disagree. The cancer sufferers themselves have been robbed of a voice. Meanwhile, more men will continue to die.

This ruling sends out the message to thousands of men – not to mention their loved ones and families – that Scotland does not care about prostate cancer sufferers. It tells them that they would be better off living in England or Wales, or Libya, if they want their government to support a means to prolong their life. The last sufferer the Scottish Government cared about was a man found responsible for the deaths of 270 people on Scottish soil. The rest of them, it seems, can simply be left to die.