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Last Updated: Monday, 14 June, 2004, 11:03 GMT 12:03 UK
Cancer tsar slams access to drugs
A survey last year suggested Herceptin is still rationed
The government's cancer tsar says there are "unacceptably high variations" in access to cancer drugs.

Professor Mike Richards found some patients are being denied drugs that have been approved by the National Institute for Clinical Excellence.

His report blames a shortage of specialist staff and facilities, and doctors' differing opinions about the merits of individual drugs.

Health Secretary John Reid pledged action to ensure more equal access.

I am determined to ensure patients across the country have access to drugs which can help them.
John Reid
Professor Richards' report said the use of chemotherapy in England had increased rapidly over the last five years.

But he said: "In some places there are capacity problems: a lack of suitable space to prepare or administer toxic drugs or shortages of specialist pharmacists, nurses or doctors."

And, despite the fact that NICE recommendations are supposed to be binding on the NHS, the report finds that the use of drugs is "heavily dependent" on whether individual doctors believe them to be useful.

Professor Richards said the problem did not appear to be linked to restrictions on funding, and he said equality of access had improved since NICE was established in 1999.

But his audit of 16 cancer drugs recommended by NICE found some people were up to four times more likely to get access to a drug than others in different areas of England.

Keep the NHS national
Wendy B, Ipswich, UK

Tougher approach

Ministers reacted to the report by promising action to ensure that NICE guidelines are better implemented across the NHS.

A system of electronic hospital prescribing, originally planned to start in 2008, will now be introduced by 2006.

This will help to pick up more easily instances where drugs are not being prescribed in the recommended way.

In the short term, a new agreement with commercial firm IMS will give the NHS access to better data on current prescribing patterns.

It is also planned to review the way NICE guidelines are disseminated both to front-line staff, and patients.

And ministers have asked the Healthcare Commission to consider how implementation of NICE guidelines could be incorporated into NHS performance ratings.

Dr Reid said he was determined to ensure all patients had access to drugs which could help them.

He said: "If we can tell doctors in one area that they seem to be using a particular drug much less than colleagues elsewhere, that provides a trigger for them to reassess their own practices and often leads to improved levels of use."

"I am confident we will be able to use this data to improve the uptake of these important drugs, while ensuring clinicians retain the final say in the treatment of individual patients."

Mr Reid ordered the government inquiry following a report on access to breast cancer drugs.

The obvious way to prevent "postcode prescribing" would be to have all drugs paid for out of a UK-wide central fund
Nicola Kerrison, Cambridge

The charity CancerBACUP showed there were significant variations in access to the breast cancer therapy Herceptin (trastuzumab) across the UK.

Derryn Borley, Head of Cancer Support Services at CancerBACUP, said: "It was extraordinary that the Department of Health didn't know if cancer patients were receiving drugs recommended by the National Institute of Clinical Excellence.

"This report confirms what worried patients tell us when they call our helpline and reinforces the findings we released last October revealing postcode prescribing across the UK on the breast cancer drug Herceptin.

"The government must now put systems in place to ensure such an investigation never has to happen again."

Jola Gore-Booth, of the charity Colon Cancer Concern, said: "UK cancer patients need reassurance that they can receive the best possible treatment for their condition.

"Action must be taken to ensure that barriers are overcome to allow access to these life-saving treatments, and ensure patients have the best chance of survival."

Derryn Borley, of CancerBACUP, said: "It was extraordinary that the Department of Health didn't know if cancer patients were receiving drugs recommended by NICE.

"The government must now put systems in place to ensure such an investigation never has to happen again."

Major threat

Cancer is a major problem in England with more than 225,000 cases and more than 120,000 people dying from cancer each year.

More than one in three people will be diagnosed with a cancer during their lifetime.

A report, Cancer 2025, due out later this week, is expected to say that the number of cases of cancer in Britain will treble in the next 20 years.

And a separate study, published by the Men's Health Forum, has found that men were almost twice as likely as women to develop one of the 10 most common cancers that affect both sexes.

The MHF found that current cancer prevention policies were not working for men.

Peter Baker, director of the MHF, said: "We need to introduce male-specific approaches to tackling the disease."

Is anyone listening to NICE?
25 May 04  |  Health


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