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Worst records for using new cancer drugs.

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Europe and U.S. shame Britain on cancer lifeline drugs

By JENNY HOPE - More by this author »

Britain has one of the worst records for using new cancer drugs.

The report says the National Institute for Health and Clinical Excellence, which decides if the NHS can fund new drugs, is meant to avoid significant delays.


NHS sentenced me to death

But researchers claim there is no evidence this objective is met, adding that 'Nice blight' stops drugs being used during the approval process. This can last 18 months, during which time the NHS is not funded for the drugs under review.

The top countries for using new cancer drugs are Austria, France, Switzerland and the U.S., according to the Swedish study by Professor Bengt Jonsson, of the Centre for Health Economics at the Stockholm School of Economics, and Dr Nils Wilking, clinical oncologist at the Karolinska Institute in Stockholm.

Uptake of new cancer drugs is 'low and slow' in the UK, New Zealand, Poland, the Czech Republic and South Africa, particularly for bowel and lung cancer.

Countries with a history of prescribing new drugs have the best five-year survival rates from the disease. Patients in countries with a poor record for using new drugs have lower survival rates.

New drugs account for between 14 and 19 per cent of the difference in death rates between high and low users.

The UK's five-year survival rates are bottom out of five leading European countries, says the report, published today in the cancer journal Annals of Oncology.

Just 53 per cent of women and 43 per cent of men beat the disease, compared with the best performer, France, where 71 per cent of women and 53 per cent of men survive.

The study shows 52 per cent of cancer patients in France, Spain, Germany and Italy were treated with drugs launched after 1985, but only 40 per cent of British patients had access to these drugs.

In the UK, around 153,000 deaths are caused by cancer each year. Professor Jonsson said: "Inequalities between countries in patients' access to cancer drugs cannot persist. Cancer patients will not accept that a standard of care available in one country is not available in other countries."

The 80-page report, which updates an earlier study by the same authors, says the UK has a good record on breast cancer drugs but highlights problems with four drugs: Avastin and Erbitix, for bowel cancer, and Tarceva and Alimta, which treat lung cancer.

The lung cancer drugs have not been approved by Nice but are available in Scotland. The use of Avastin in the U.S. is ten times higher than the European average, with the UK rated as having "very low" uptake.

Consultant medical oncologist Gary Middleton, of the Royal Surrey Hospital, Guildford, said the report was a "shocking indictment".

He added: "I treat both colorectal and lung cancers and on a day-today basis I am faced with disappointment and frustration at not being able to give the drugs that I know will make a difference to my patients' quantity and quality of life, purely because they are deemed too expensive by Nice.

"The yawning gulf between the private sector and the NHS widens further by the day with a standard of care for patients treated privately or by the NHS being completely different.

2When I treat a patient privately I am simply providing them with the sort of care that they receive in the rest of the developed world and when I treat them on the NHS I play the constant game of finding alternative treatments which I know are nowhere as near as effective but at least are cheap."

Cancer charities said NHS patients were being penalised as a result of negative Nice guidance, NHS cash restraints and restrictive local practices. Ian Beaumont, of Bowel Cancer UK, said: "It's the patients who are probably going to die - yet have the chance to live longer and better lives as a result of these drugs - that are instead forced to fight bureaucracy instead of the disease and to make sacrifices they and their families can ill afford in terms of money, time and energy to get them."

Mike Unger, chief executive of the Roy Castle Lung Cancer Foundation, said the report showed the massive inconsistencies in treatment options for lung cancer patients in the UK compared with the rest of Europe and the U.S.

He added: "Patients are being seriously misled into believing they can benefit from new drugs licensed for use on the NHS, even after taking part in clinical trials which show they work, because they're then rejected on cost grounds."

Shadow Health Secretary Andrew Lansley said: "If we are going to achieve five-year survival rates from cancer that are among the best in the world, then we must ensure that more patients are widely enrolled in clinical trials and drugs which demonstrate effectiveness are adopted quickly."

A spokesperson for the Department of Health said "We are making good progress in ensuring cancer patients have access to the drugs they need."

• NHS sentenced me to death

Petition: Mrs Barnes, with husband Fred, got 6,000 signatures

Maureen Barnes feels she was left to die by the NHS after being diagnosed with the lung cancer mesothelioma.

She was told her primary care trust would not pay for Alimta, the only treatment that delays advance of the disease.

Mrs Barnes had been in and out of hospital for 12 years with unexplained symptoms before tests showed she had a cancer of the lung lining linked to asbestos exposure.

She may have inhaled the dangerous fibres because her first husband worked in the asbestos industry.

Mrs Barnes, 61, who lives with her husband Fred near High Peak, Derbyshire, was outraged after her cancer specialist was denied funding for the drug by her local primary care trust. She said: "To find out you have a disease like this and then find you can't have the only licensed medication is a hard thing to face.

"For the first month I couldn't do anything. I felt in despair. But then I decided to fight to get the funding."

Mrs Barnes collected 6,000 signatures on an appeal petition and friends helped her pay £3,000 for her first course of Alimta treatment, after which Derbyshire PCT relented.

She said: "I feel great and the doctors say I've had a very positive response. The drug has stopped the cancer growing and shrunk it from round the heart area.

"But it's appalling that I was prevented from being treated because I have the wrong postcode. If I lived four miles down the road in a different PCT area I would have got it."

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