Today the Government will be warned it must review its NHS Cancer Plan to tackle the future pressures of an ageing population and expensive new drugs. Following funding rows over drugs such as Herceptin, Avastin and Erbitux, Health Reporter Emma Brady looks at whether NHS coffers can cope with the influx of new treatments
Today, more and more people are living with cancer as a result of improved diagnostics, shortened waiting times, and a host of new drugs and treatments.
But unfortunately this all comes at a price - and it's not cheap.
As the ageing population grows and pharmaceutical costs rise, the pressure on NHS budgets is set to worsen if the Government does not plan for the introduction of new drugs now.
Yesterday the National Institute for Health and Clinical Excellence (Nice) rejected an appeal by Newbury and Community Primary Care Trust against its recommendation that all PCTs should fund breast cancer drug Herceptin.
But earlier this week two new bowel cancer drugs - Avastin and Erbitux - were not approved on the grounds they were too expensive to be provided on the NHS.
Before its Nice approval for early stage HER2-positive breast cancer, Herceptin cost £20,000 for the drug alone, but PCTs faced bills of between £30,000 and £35,000 per patient.
In comparison, Avastin - also called bevacizumab - costs £924.40 per 400ml vial and patients in clinical trials were given an average of 18.2 vials, which adds up to £16,824.08.
Nice's assessment of this drug states "the likelihood of bevacizumab being cost effective is zero".
Erbitux, also known as cetuximab, costs £136.50 per 50ml vial. Patients received a loading dose of seven vials followed by maintenance doses of five vials, with an average of 16.8 doses being administered at a cost of £11,739 per patient.
Both these drugs come under the £30,000 cost threshold imposed by Nice on new drugs.
But that is not based on net cost. Instead, it is calculated on a "quality-adjusted life year" (QALY) score which takes into account its effectiveness, side effects, response rate and value-for-money.
Former Tory Minister Ann Widdecombe yesterday criticised the Government for wasting money on telling people to get fitter while life-saving drugs were turned down on cost grounds.
Ms Widdecombe said it was time the Government stopped dictating the obvious to the public and "we took responsibility for ourselves".
She said: "I think there are an awful lot of people who cannot get the drugs they need on the NHS, and who can't get the treatment they need, who are going to say why on earth should any NHS priority be poured into trying to persuade people to do something relatively easy, look after themselves?"
Nice's final guidance on Herceptin, in June, recommended the drug be given to eligible women with HER2-positive breast cancer, except those with heart problems. But Newbury and Community PCT's appeal was brought following cost concerns.
This seems a far cry from the situation breast cancer patients in the Midlands found themselves in when it emerged patients on the other side of the Welsh border were getting the treatment without any fuss, following approval by the Welsh Assembly.
In May mother-of-two Sharon Moore, from Much Wen-lock, in Shropshire, staged a four-day sit-in at Shropshire County PCT in a bid to persuade it to revise its Herceptin prescribing policy.
The 45-year-old only had six days left in a six-month window when the drug would be most effective against breast cancer.
On the fourth day trust bosses relented and granted Mrs Moore the drug, promising to review "outstanding individual cases".
If a second Cancer Plan is not drawn up by 2010, more drugs could be written off on cost grounds. But the real cost would be patients' lives.
