Plea for '˜national debate' on who gets NHS cancer drugs

The NHS in Scotland is struggling to understand which patients should receive new life-extending cancer drugs, a key Scottish Government health adviser has admitted.
Michael Young, who petitioned to receive a muscular dystrophy drug. Picture: Ian GeorgesonMichael Young, who petitioned to receive a muscular dystrophy drug. Picture: Ian Georgeson
Michael Young, who petitioned to receive a muscular dystrophy drug. Picture: Ian Georgeson

The challenge of deciding how the new generation of treatments are allocated has led to Dr Brian Montgomery calling for a national conversation to debate the complex issue.

Montgomery spoke to Scotland on Sunday ahead of the publication of a major review he has conducted for health secretary Shona Robison on how to balance the rising demand for increasingly effective and expensive drugs within a limited budget.

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His “Review of Access to New Medicines” has been passed to Robison and this week he will address a conference titled “The Future of the NHS in Scotland: Innovation, Efficiency and Realistic Medicine”.

Montgomery said: “The challenge there is we have more and more drugs coming on, some of which seem to offer hope, others more marginal benefits, and a lot of the cancer treatments while they are not curative have the potential to offer enhanced duration of life or enhanced quality of life or both. And the thing we are struggling with at the moment is understanding and knowing the people that will get most benefit from these and the circumstances under which to use them.

“You tackle that by having a very big conversation which is about more than just the individual medicines but trying to work out what really are our priorities that we the population of Scotland have for our health service and indeed have for the services that support our health services.”

Recent high-profile cases have cast the spotlight on the availability of new drugs which can extend the lifespan of seriously ill patients.

Breast cancer sufferer Anne Maclean-Chang only managed to get access to the new drug Kadcyla after her case was publicised in the press. When her case was brought up at First Minister’s Questions by Labour, Nicola Sturgeon announced that she would receive the drug.

Nine-year-old Michael Young had to embark on a long campaign to get the drug Translarna to treat his muscular dystrophy.

After more than 139,000 people backed his petition, Young was pleased to receive a letter from Sturgeon 
saying he would get the treatment.

Montgomery said: “There is a huge issue about affordability. There are now many more treatment options available than we necessarily can afford as things currently stand. For me it is about choices. That’s where it is about that wider conversation. These are not choices that should be made by doctors and health service managers or indeed politicians. These are choices that need to be made by the wider population.”

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A Scottish Government spokesman said: “The Cabinet Secretary will consider the recommendations carefully once she receives the report. The Scottish Government agrees these are important issues, and that is precisely why Prof Montgomery was asked to do this review. The Scottish Government is committed to increasing funding in the NHS while reforming it, and access to medicines is a key part of that.”