New NHS rationing plan could mean more dying patients are denied life-extending medicines, charities fear.
Thousands of terminally-ill cancer patients could be denied life-extending drugs under new plans from the NHS rationing body, charities say.
The National Institute for Health and Care Excellence (Nice) will today announce proposals to change the way it decides which medicines the health service should fund.
The body was asked to change its funding formulas to ensure the NHS gets best value from the drugs it funds.
But last night charities said the new proposals amounted to a “devastating” attack on cancer sufferers – which could mean more than 12,000 terminally-ill patients a year are denied drugs they currently receive.
Under its existing formula, Nice uses “end of life” criteria to approve some drugs if they are the only hope of extending life, and might otherwise have been ruled out on cost grounds.
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The criteria is among several considered before decisions are taken about which drugs to fund.
Since the rules were introduced in 2009, 12 drugs for major cancers including those of the prostate, liver, stomach and blood have been recommended, for more than 12,000 patients a year, Department of Health figures show.
But the new proposed formula removes the “end-of-life” criteria.
Instead Nice’s committees will try to assess the burden of illness on individuals, the wider impact on society and other objectives – such as whether a new drug is innovative -before taking decisions.
An earlier draft – which said drugs should be recommended if it brought benefits to wider society – has been rewritten amid concerns that pensioners could be denied drugs because they did not contribute economically.
The new proposals specify that the impact of society should only compare those of the same age.
Charities last night accused Nice of trying to bury a new set of proposed changes which would affect the most vulnerable.
Andrew Wilson, chief executive of The Rarer Cancers Foundation said: “This is a complete betrayal of the Government’s manifesto promise to ensure that patients that they would be able to access the drugs their doctor recommended.”
He said the proposals were a “backward step for cancer” which could shorten thousands of lives.
Mr Wilson said: “Plans to abolish special rules for drugs used near the end of a patient’s life have been slipped out in the small print of this consultation. They amount to a stealth cut for cancer and could have a devastating impact on access to life-extending drugs, with no guarantee that other changes to the rationing formula will compensate.”
Mark Flannagan, Chief Executive of Beating Bowel Cancer, said: “Anything new approach that simply moves the goal posts will be met by dismay by cancer patients. Any system which doesn’t lead to patients accessing latest cancer medicines is fundamentally flawed. It’s accepted that access to new cancer medicines has changed the quality of life for thousands of cancer patients. NICE must listen to the views of patients and charities and create fair access which is right for a 21st century health system.”
Paul Catchpole, director of value and access at the Association of the British Pharmaceutical Industry (ABPI), said the current process already denied too many cancer patients medicines and that he was concerned that the new rules could worsen the situation of the terminally ill.
He said: “We have a particular concern about the potential impact of incorporating Nice’s existing ‘end of life criteria’ into the new system. We need to ensure that this does not lead to fewer medicines for patients at the end of their life being approved.”
The rationing body has repeatedly been criticised for failing to recommend drugs despite evidence supporting them.
Since 2007 the body has recommended less than one in three medicines it reviewed.
In the document, Nice says the new methods of measurement aim to ensure that the full burden of illness – both the loss in quality and length of life – are taken into account “more explicitly and systematically” as well as wider impacts on society.
Andrew Dillon, chief executive of Nice said: “These proposed changes to the way we value new treatments will add further clarity to our recommendations and enable our independent advisory committees to explore more fully the potential these treatments have to improve outcomes for patients.”
He added: “No patients will miss out on effective and cost effective treatments due to these changes.”
Earlier this week Nice rejected the drug Zaltrap (aflibercept) for the treatment of advanced metatstatic bowel cancer- just two weeks after the drug was approved in Scotland.
Doctors accused Nice of allowing cancer patients to die prematurely in rejecting the drug, estimated to cost around £44,000 a year, while charities said it was unfair that patients were penalised for living south of the border.
Last March the rationing body rejected the drug Afinitor (everolimus) which costs about £36,000 a time on grounds of cost, saying there was no evidence it was better than treatments already available.
But trials have shown it can stop tumours spreading for nearly eight months – twice as long as alternative drugs.
In the same month, the body turned down Inlyta (axitinib) for kidney cancer, even though studies suggested it helped some patients live an extra three years.
In May last year, Nice rejected Avastin (bevacizumab) for ovarian cancer despite trials showing that patients given the £25,000 drug alongside chemotherapy lived 50 per cent longer, surviving just over a year on average.