Lyndsay Buckland: NHS dilemma over cancer drugs

DEALING with cancer is an expensive business. Not only can diagnosing and treating the disease take a long time, but the drugs that have been developed in recent years seem to come with an extra long price tag to fit all the zeros in.

Kadcyla has been shown to extend life expectancy by an average of six months. Picture: Phil Wilkinson
Kadcyla has been shown to extend life expectancy by an average of six months. Picture: Phil Wilkinson

This poses a dilemma for a cash-strapped NHS. How can it justify paying tens of thousands of pounds for treatments that may only extend a patient’s life for a few months when budgets are being squeezed?

Set against this are real people just wanting to spend a bit more time with their families, wrapping up their affairs, doing all the things they hoped they would have a lifetime to do before cancer struck.

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Next week, this dilemma will raise its ugly head again as the Scottish Medicines Consortium (SMC) meets in public to discuss the breast cancer treatment Kadcyla and whether it should approve it for use by the NHS.

The drug has proved controversial as it has already been rejected by watchdogs in England who decided the benefits did not justify the costs.

The decision sparked much disappointment among campaigners, but there is hope that Scotland will take a different route and offer those women with the type of breast cancer targeted by Kadcyla routine access to the treatment.

Breakthrough Breast Cancer described the drug as innovative, working in a different way to other treatments by better targeting chemotherapy to the diseased cells. It has been shown to extend life expectancy by an average of six months. The drug costs £90,000 per patient, but manufacturer Roche said it had offered a lower, undisclosed price in talks with English assessors. A similar deal may have been offered to Scotland, but whether it will be enough to tip the balance remains to be seen.

There are no simple answers in this long-running debate. The Scottish Government has introduced measures that it says should improve fairness in the decision-making process on new drugs.

But there needs to be a bit of give and take on both sides.

Drugs companies need to recognise that the NHS is not a bottomless pit of money that they can dip into and adjust their prices accordingly. Yes, developing drugs is an expensive business, but it’s also a pretty pointless one if nobody gets to benefit from them.

At the same time, the NHS and those in charge of assessing drugs need to place greater value on those extra months of life these treatments can give patients and their families.

The SMC’s decision on Kadcyla will not be made public until October. A lot of people will be eagerly awaiting the outcome. Let’s hope a solution can be found that suits everyone.