Patients left begging for medicines and facing cruel assessments, says report
The way drugs are approved for NHS use is leaving some patients begging for medicines, a new report suggests.
The way medicines are assessed can be cruel and leads to some patients being thrown out of the lifeboat, said academic David Taylor, emeritus professor of pharmaceutical and public health policy at University College London.
He said cost-saving exercises are being put ahead of health improvement and if drugs were paid for appropriately, then definitive treatments for cancer could be developed in 20 to 30 years.
Meanwhile, the proportion of gross domestic product (GDP) spent on fast food is 15 times higher than the proportion spent on anti-cancer drugs, he added.
Prof Taylor said Britain spends 1% of GDP on pharmaceuticals but in France, Germany and the US this figure stands at around 1.5% to 2%.
The proportion of NHS money spent on medicines has remained largely the same for the last five decades – with around 10% of the health service’s resources spent on drugs, according to the report, which was funded by the Association of the British Pharmaceutical Industry.
Prof Taylor said that the UK was lagging behind places like Germany where drugs and other medical innovations are made available to the public as promptly as possible.
At the launch of the report, Prof Taylor said: “We are in danger of pursuing savings at any cost.
“Badly pursued, simplistic health economics is encouraging people to behave as though there is no tomorrow.
“It’s stacking the desire to consume now and get things as cheaply as possible and rewarding that against the long-term issue that we know if we go on investing appropriately over the next 20 or 30 years we really will have definitive treatments for most cancers, we really will be able to manage most neurological disease.
“We have created a culture which is in danger of putting cost saving before health improvement.”
He continued: “The current approach in the UK is on occasions cruel, uncaring and unacceptable in the sense that some individuals are having to beg for better care.
“It doesn’t mean the whole system is wrong but it seems to me to have an edge of uncaringness.”
Prof Taylor added: “The NHS is in danger of being fatally undermined by accepting unduly low cost effectiveness thresholds coupled with narrow measures of value.
“We have a system which effectively means that some people are thrown out of the lifeboat altogether and other people are left to feel they won’t get access unless they beg.
“The NHS, because it is publicly funded, could do much better than that. We have reduced it to an American-type private system by having thresholds where you won’t get access if you are too expensive.”
He added: “Anti-cancer medicines cost a little over 0.1% of GDP.
“If we take fast food alone, we are talking between 1.5% to 2% of GDP.
“You could say the same for soft drinks – they cost as much as all NHS medicines.”
The new report states: “The use of narrowly defined measures of value combined with relatively low cost effectiveness thresholds can conflict with the NHS’s duty to provide good care to everyone.
“It sometimes leads to people feeling that they have to beg for treatments that their doctors believe could benefit them.”
The report calls for England and other UK nations to seek a “humane” approach to valuing innovative medicines.
It says that a new system should combine greater freedom of “case by case” decision-making with the cost effectiveness of medicines offered for NHS use while assuring overall health care system affordability.
Meanwhile, seriously ill patients should have “timely and assured” access to treatments, the report Affording The Future? adds.
Sir Andrew Dillon, chief executive of the National Institute of Health and Care Excellence (Nice), said: “Nice’s approach to making recommendations for new drugs is widely regarded as the fairest and most robust in the world.
“We use a measure of how much a patient’s health-related quality of life improves to help us decide when a new drug represents good value for money because that allows us to decide when a new treatment provides more benefit to patients than spending the same amount of money on something else.
“This is essential in making sure that the NHS uses its funding wisely and fairly.
“Germany funds its health service differently from the NHS and the system it uses to decide what treatments to fund takes account of those differences.
“It’s worth pointing out that their recent proposals for change would, if put in place, place limits on what is currently one of the most generous approaches to funding new drugs.”
Copyright (c) Press Association Ltd. 2016, All Rights Reserved. Picture (c) Julien Behal / PA Wire.
