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Last Updated: Friday, 6 October 2006, 16:05 GMT 17:05 UK
Why can't patients pay for NHS drugs?
By Jane Hughes
BBC News, Health correspondent

Anni Matthews
Anni Matthews received the drug on a trial
The developers of a groundbreaking new breast cancer drug are expected to file for a licence to sell it in this country within the next few days.

Trials suggest Lapatinib (brand name Tykerb) is effective on some women with advanced breast cancer who no longer get benefits from taking the drug Herceptin, and on women who are unable to take Herceptin because of side effects.

Like Herceptin, it targets the HER2 protein, which can fuel the growth of breast tumours. About one in five beast cancers carry an excess of HER2 proteins.

Unlike Herceptin, it also targets the HER1 receptor, and it may also act on secondary tumours in the brain.

It is not a cure for cancer, but it appears to give patients an average of a few months longer to live.

Anni Matthews has advanced breast cancer which has spread to her lungs, and in 2002 she was told she only had two years to live.

I can't see how this country can spend millions of pounds on drug research and then turn round and say, I'm terribly sorry we can't afford it
Anni Matthews

She took Herceptin for two and a half years, and began taking Lapatinib in March when Herceptin stopped being effective.

She had seven tumours in her lungs, and she says all but one seems to have disappeared since she began her new treatment.

She has experienced side effects, including stomach upsets and bleeding from her eyes, nose and fingernails, but she feels so well she is still able to lead a normal life including playing tennis twice a week.

One of the few

Anni is lucky, though. She is getting Lapatinib because she is taking part in a medical trial.

If the drug is licensed in Europe, other patients will have to pay for it, unless the NHS decides to fund it.

Cancer experts estimate it will cost about 25,000 a year.

And patients would also have to pay for the rest of their cancer treatment privately, which would cost at least another 25,000, because they are not allowed to "top up" their NHS treatment by paying privately for new drugs.

Anni believes Lapatinib should be available on the NHS.

"I can't see how this country can spend millions of pounds on drug research - encouraging companies to seek a cure for cancer - and then turn round and say, I'm terribly sorry we can't afford it," she said.

Rethink needed

A leading oncologist, Professor Karol Sikora, says the time has come for the NHS to rethink the way expensive cancer drugs are funded.

This could mean you'd get a patient in one NHS bed who can't have the drug next to a patient in the next bed who can
Tony Harrison
King's Fund

He believes patients should be allowed to "top up" their NHS treatment and pay for drugs themselves if their Primary Care Trusts won't fund them.

"I think there's no alternative," he said.

"In the next five years there are about 40 new cancer drugs coming along. They will all cost about 40,000 or 50,000 a year.

"The NHS simply can't afford them unless it gets an even bigger increase than it's had in the last ten years."

But the medical think tank, the King's Fund, is fundamentally opposed.

"The NHS is based on equal treatment for equal need," says Tony Harrison, a senior fellow in health policy.

"This could mean you'd get a patient in one NHS bed who can't have the drug next to a patient in the next bed who can, and that would be so obviously inequitable."

The Department of Health said it's not an option being considered at the moment.

A spokesperson said it would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.

Research is ongoing into whether Lapatinib might be effective against other forms of cancer.

And while that continues, so will the debate about how this and other new cancer drugs might be funded in the future.




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