Kidney cancer drugs too costly for NHS

Four new drugs to treat advanced kidney cancer have been rejected by the government's drugs advisory body as too expensive for use by the NHS, various news sources report today.

Although the drugs were acknowledged to provide "substantial benefits" and were judged to provide "significant gains" in survival, the National Institute for Health and Clinical Excellence (NICE) has refused approval on the grounds that the NHS cannot afford to provide them to patients.

More than 7,000 people are diagnosed with kidney cancer annually in the UK, with around 1,700 of those diagnosed with advanced kidney cancer.

The drugs cost between £20,000 to £35,000 a year per patient, but even at the upper end of this scale the total cost of providing the drugs to all the 1,700 patients for a year - at just under £60m - is a tiny fraction of the £115m every week the government lavishes on the audit-failing EU. Priorities?

The decision to issue draft guidance rejecting Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) has outraged charities, kidney specialists and campaigners.

Experts have reacted angrily to the decision, saying it left them with little option for treating patients.

Although there are treatments available, none of them "cure" advanced renal cell carcinoma or cancer that has spread from the initial tumour. But they can help extend a patients' life by around five to six months.

Quoted in the Times report, John Wagstaff, an honorary consultant in medical oncology at the South Wales Cancer Institute in Swansea and director of the Wales Cancer Trials Network, said there was “no point” in him accepting referrals for people with advanced kidney cancer because about 75 per cent of them “do not gain any real benefit” from interferon. The only other option, he said, was to make patients comfortable in their last months.

The draft guidelines for England and Wales, which are subject to appeal, recommended people already on the drugs should be able to continue therapy.

In the BBC's report, Pat Hanlon from Kidney Cancer UK said that the drugs provide a 'considerable benefit' and Professor Peter Johnson, from Cancer Research UK, said they had shown a small but definite improvement in an illness where there are few alternative treatments.

It's easy to cast NICE as the villian of the piece, but in trying to get the best out of limited resources they have a very difficult job to do.

In reality, in agreeing to pay an unjustifiable 63% extra to the undeserving EU, it is the government and the MPs who voted to approve that deal who are solely to blame when there's no public money left for life-prolonging drugs to be made available on the NHS.

Access to arthritis drugs denied

Around 60,000 people in the UK with rheumatoid arthritis (RA) are being denied access to potentially life-changing drugs - reports ITV News today.

A decision by the National institute for health and clinical excellence (NICE) will mean that patients will not able able to try a second anti-TNF (tumour necrosis factor alpha inhibitor) if their first attempt at the therapy fails.

Anti-TNF therapy drugs - adalimunab, etanercept, infliximab - can slow the progress of disease and help to reduce symptoms such as joint pain, swelling, mobility and fatigue.

NICE said that giving patients two, or even three, anti-TNFs is not 'cost-effective' and that doctors should offer patients the next drug in line - rituximab - which costs about £3,000 less per year than the cheapest anti-TNF.

This is yet another example of health services restricting effective drugs on the grounds of costs that, if provided, could greatly improve many people's quality of life. All the while the government shamefully continues to waste an astonishing £115m a week on the audit-failing European Union.

Charities have said that moving from one therapy to a second or third has been established practice in the UK for years and the change could leave sufferers with pain and the possibility of long-term disability.

Rob Moots, ARMA clinician and professor of rheumatology at Liverpool University, said: "It's almost impossible to know which anti-TNF will work for a patient at the outset.

"Before this decision we could try patients on each of the three treatments in turn to find one that was effective for them - now we only have one shot at success.

"This flies in the face of clinical judgment. Many patients will be left in astonishing pain, while knowing we haven't explored all the options for them."

The British Society for Rheumatology Biologics Register shows that around 70% of patients will get a good response from a second anti-TNF if the effects of the first start to wane.

Ailsa Bosworth, chief executive of the National Rheumatoid Arthritis Society, said the move, combined with a Nice decision in April to reject the drug abatacept, meant effective therapies for arthrities provided by the NHS had been cut from five to two.

She added: "This decision is another nail in the coffin for the treatment of RA in England and Wales.

"Nice are re-writing the rules of RA treatment in this country, ignoring the clinical effectiveness of drugs and ignoring the views of patients and clinicians.

"Nice is systematically taking away clinically effective and proven treatments from patients and giving them just one roll of the dice when it comes to Anti-TNF treatment."

Ros Meek, director of the Arthritis and Musculoskeletal Alliance (ARMA), said: "Nice's decision takes away access to a normal and independent life for the many thousands of people battling with the condition.

"It also totally contradicts Lord Darzi's pronouncements in his recent review of the NHS - in particular his focus on patient choice and patient empowerment.

"It's a prescription for pain."

A spokeswoman for Nice said: "Nice has not yet issued final guidance to the NHS. Consultees now have the opportunity to appeal against the draft guidance. Subject to an appeal being received, guidance is expected in September 2008."

Salford: Woman fights for NHS cancer drug

A woman terminally ill with kidney cancer could now be given a drug which could prolong her life, after a High Court ruling - reports ITV News.

Sutent has not yet been approved by the government and is not automatically available on the NHS.

Jean Murphy, a 62-year-old grandmother from Salford, had twice been denied the drug by Salford Primary Care Trust on the grounds that it is too expensive.

Dr Mike Burrows from the trust said before the ruling: "We have a limited amount of resources and have to make decisions on which treatments we are prepared to fund and which we cannot fund. We have to use health economics to support those decisions."

Ruling on the case, Mr Justice Burnett said the Trust's commissioning panel had failed to consider Mrs Murphy's application "in the round", and to take into account her day-to-day responsibility for caring for her husband who has a heart condition and diabetes.

This is yet another example of how the abject waste of £115 million a week paid to the audit-failing European Union - an unjustifiable 63% increase on the annual amount Britain paid between 2001-06 - is causing real suffering and shortfalls in essential public services.

In particular, Salford MP Hazel Blears needs to explain why she voted to approve paying this extra money to the EU while her local hospital clearly cannot provide services her constituents need, and blame a "limited amount of resources".

With public finances tightening, we can no longer afford to hand over so much money to the European Union. Especially as the "majority" of the EU's spending has not been approved by auditors for 13 years running, and there are so many reports of waste and fraud - going on even within EU institutions themselves.

Evidence continues to grow that it's time to Stop the Cheques to the EU.

Norfolk: Retired fireman loses battle for cancer drug

A retired fireman has suffered a setback in his battle to win funding for a cancer drug, reports the Eastern Daily Press.

Liver cancer patient Barry Humphrey has lost an appeal for a £5,000 trial for a drug aimed at buying him more time.

His upset wife Hazel says health bosses have “sentenced him to an early death” though their latest decision.

After 25 years service saving lives as a fireman in London, Mr Humphrey developed a rare cancer, triggered by hepatitis caught from a casualty during a rescue.

But officials at NHS Norfolk have decided not to fund treatment recommended by his consultant, saying Mr Humphrey's case fails to meet national cost-effectiveness guidelines on new drugs.

The couple, from Kimberley Road, are now seeing if there is anywhere else they can take their fight.

Funding the two-month trial treatment themselves was a last option - but they were reluctant having been told they would be opting out of the NHS, resulting in them having to pick up all treatment costs.

Fewer than 5% of liver cancer patients survive more than five years, so time is not on the Humphreys' side without some kind of treatment. And Barry says his consultants believe there are no other alternative drugs.

NHS Norfolk medical director Bryan Heap said treatment funding decisions were taken on clinical rather than social circumstances, so Mr Humphrey's past as an exemplary citizen unfortunately could not be taken into consideration.

The cost of Sorafenib, along with administration, extra scans and follow-up was £150,000 a year, and trials indicated an increase in life expectancy of 12 weeks, with no cure or reduction of symptoms.

Guidelines recommended not funding a new drug if the figure was greater than £30,000, he added.

North Norfolk MP Norman Lamb, the Liberal Democrats health spokesman who has been backing Mr Humphrey's battle, said he was “horrified” by the appeal refusal, and would be seeking to meet a senior official from NHS Norfolk to argue the case.

Woman 'denied sight-save drugs'

A grandmother has said she will go blind unless she can persuade her local NHS to fund drug treatment - reports the BBC.

Margaret Coates, 79, from Bromley, south-east London, has wet age-related macular degeneration (AMD), which can lead to blindness in both eyes.

Her local Primary Care Trust (PCT) will not pay for a drug called Lucentis, Mrs Coates said.

Bromley PCT said patients who did not meet London-wide treatment criteria could apply for exceptional treatment.

Wet AMD, which affects the central part of the retina, is the leading cause of sight loss in the UK, affecting around a quarter of a million people.

Last year the National Institute for Health and Clinical Excellence recommended that NHS patients with wet AMD should be eligible for sight-saving drug Lucentis.

But the availability of the treatment, which can cost thousands of pounds, varies between PCTs.

Mrs Coates, 79, said: "I can't believe the PCT is abandoning me like this when I could lose my sight.

"The thought of going blind terrifies me"

The Royal National Institute of Blind People (RNIB) and the Macular Disease Society (MDS) are campaigning for Bromley PCT to reverse its decision and fund the treatment.

Bromley PCT said it funds Lucentis treatment for Bromley residents with AMD in line with criteria agreed for the whole of south-east London.

"Patients who do not meet these criteria can apply through their clinician to the PCT's exceptional treatments group," a spokesman said.

In order to qualify there must be an "unusual or unique clinical factor" that differentiates the patient from others with the condition, he said.

Kidney cancer man's drugs fight

A man with kidney cancer says he has been refused a drug that could save his life and is still waiting for treatment 18 months after being diagnosed - reports the BBC.

Jocelyn Hall, 60, of Tonna, Neath, is taking his local health board (LHB) to judicial review after it refused to pay for him to have the drug, Sunitinib.

Neath Port Talbot LHB said each case for the drug was reviewed individually.

Mr Hall was diagnosed with kidney cancer in September 2006, a fortnight after he gave his notice so he could retire after working in Neath's Metal Box can factory for 44 years.

Surgeons were unable to operate because his tumour had spread to other organs.

Mr Hall's oncologist at Swansea's Singleton Hospital, Professor John Wagstaff, said the drug treatment he wanted his patient to have cost £2,300 every six weeks.

He said: "I've got a number of patients in exactly the same situation, not just with Neath Port Talbot but with other LHBs in south west Wales.

"It's a continuing battle. If he does not get this drug, the only management available to him is to control his symptoms."

Mr Hall's sister, Rosemarie Snow, said: "He has worked all his life and paid into cancer research all his life and he's got nothing.

"The drugs won't cure him but they will help prolong his life. After he worked 44 years of his life, he wants to enjoy his retirement.

Kate Spall, who has become a patient support advocate since her mother died from a rare kidney cancer, said Mr Hall was the "most exceptional" of the more than 40 cases she had advised.

She said: "He has not treatment for nearly two years for terminal cancer. That is just unheard of.

"In Wales today, somebody has not had had one piece of active treatment. That's Third World. That's unbelievable."

A spokeswoman for Neath Port Talbot LHB said she could not comment on individual cases because of confidentiality.

But she said that the local health board took guidance from the All Wales Medicines Strategy Group, which said the use of Sumitinib should not be supported in Wales.

Warwickshire: Man in NHS battle 'to save sight'

A man has called his NHS trust "morally wrong" for refusing to fund treatment which could save his sight - reports the BBC.

Raymond Liggins, 76, from Nuneaton, lost the sight in his left eye because of wet macular degeneration and now has the condition in his right eye.

Warwickshire Primary Care Trust has said that it did not routinely fund the "sight-saving" drug Lucentis as it was not recommended in guidance to the NHS.

David Rose, chief executive of Warwickshire PCT, said this was the same as other PCTs in the West Midlands.

But Mr Liggins' case has been backed by the Royal National Institute of Blind People (RNIB) and the Macular Disease Society (MDS).

The RNIB said Mr Liggins had the devastating condition age-related macular degeneration (AMD) which could lead to blindness in as little as three months.

It called for Warwickshire PCT to adopt draft guidance from the National Institute for Health and Clinical Excellence (NICE) which recommended Lucentis be made available to all patients who developed AMD.

The RNIB said rapid use of the drug was "vital" as it was able to halt the progress of the condition.

Mr Liggins, who is using his life savings to pay for private treatment, said he and other patients with the condition had been "let down" by the NHS.

"It's morally wrong to let people go blind when there are treatments available," he said.

Mr Liggins, who cares for his wife Olive who recently had a stroke, added: "My wife depends on me to help maintain her balance when we go out shopping, but I won't be able to do this if I lose my sight."

Barbara McLaughan, RNIB campaigns manager, said: "It's an absolute disgrace that he is effectively being told to pay up or go blind," she said.

She added: "The clock is literally ticking for patients like Raymond who risk losing their sight because PCTs are denying them sight-saving treatment."

Mr Rose said it was not appropriate for the PCT to comment publicly on an individual case.

He added: "The National Institute for Health and Clinical Excellence (Nice) issues guidance to the NHS on treatments and procedures following extensive trial and review and Warwickshire PCT follows all mandatory NICE guidelines.