'Devastating divide' in access to new cancer drugs

The report suggested patients in Scotland were less likely to have access to new cancer drugs

A cancer charity has warned that a "devastating divide" has opened up between England, Scotland and Wales when it comes to accessing new drugs.

According to research by the Rarer Cancers Foundation (RCF) people in Scotland are three times less likely to get access to a newer cancer drug than their neighbours in England.

In Wales patients were five times less likely to get access to the treatments.

The Scottish government said it had concerns over the quality of data used.

Using the Freedom of Information Act, the RCF gathered data from health trusts in England on the types of drugs approved through the UK government's cancer drugs fund.

The fund, worth £200m a year, was set up for patients in England to access drugs approved by their doctors but which have not been given the go-ahead for widespread use on the NHS.

The data was then compared with exceptional case approvals for the same drugs in Scotland and Wales.

The charity said that if levels of access were the same across the UK, then 248 more patients would benefit each year in Scotland.

The report also said comparable levels of access for people in Scotland and Wales could be delivered at a cost of only £1 per person per year.

Andrew Wilson, chief executive of the RCF, said: "The cancer drugs fund is great news for people in England and has already benefited thousands of patients.

"However, a devastating divide has opened up with Scotland and Wales.

"A cancer drug does not become any less effective simply because it is prescribed on the other side of a border. Nor does a patient's need become any less pressing."

He added: "The NHS should be there when you need it the most, regardless of where you live.

"People in Scotland and Wales will want to know why their chances of accessing a life-extending cancer drug are so much lower than their neighbours in England."

A spokeswoman for the Scottish government said it would carefully review the report, but had concerns over the quality of the data used and the conclusions drawn from it.

She said: "Three of the medicines listed in the report as not available in Scotland have actually been recommended for use in certain circumstances.

"In five other cases the medicine cannot be recommended for use in Scotland because the pharmaceutical company has not made a submission to the Scottish Medicines Consortium.

"We would encourage the pharmaceutical companies concerned to make submissions to the SMC so that their clinical and cost effectiveness can be assessed."

She said Scotland had "robust, equitable and transparent" arrangements for the introduction of newly-licensed clinically and cost-effective medicines through the Scottish Medicines Consortium and Healthcare Improvement Scotland.

"There is flexibility for additional factors to be taken into account in prescribing decisions and boards can make 'not recommended' drugs available for individual patients in certain circumstances," she added.

"The vast majority of patient treatment requests for 'not recommended' drugs are approved."

Dr Chris Jones, medical director of NHS Wales, said they did not see a need for a separate cancer drug fund in Wales.

"We already spend approximately £5 more per head of population than England on cancer treatment," he said. "Even with the additional £200m available in England, it is still less than what we spend per head in Wales.

"There also appears to be no guarantee that all patients who request a given medicine will receive it even with the cancer fund."

He said all new medicines deemed clinically and cost-effective by Nice or AWMSG were provided on the NHS. Additional funding was provided to appraise more new medicines for use in Wales before Nice considers them and therefore these would be "routinely available" in Wales ahead of England.

"Where medicines are not approved, or are waiting approval, mechanisms are in place to ensure access for patients in exceptional circumstances," said Dr Jones.

"It is important to note these new medicines are often initially marketed with much promise and limited evidence of effectiveness and sadly do not save lives. Some of these medicines can also have significant side effects which can impact on quality of life."