NHS Top Up Payments Should Be Allowed For Cancer Care, UK
Writing in the Journal of the Royal Society of Medicine, Professor Karol Sikora said paying for cancer care was the new dilemma for the NHS.
"Over the next 12 months there will be at least six new powerful targeted anti-cancer drugs administered as simple tablets for breast, lung, kidney and colorectal cancer.
"These drugs inhibit tyrosine kinases, a key signalling system in cells, and will cost at least £60,000 per patient per year. It is unlikely the NHS will be able to afford any of them and in any case the NICE backlog will delay their assessment for at least a year."
Professor Sikora said that paying for new drugs was only one part of the cancer care dilemma.
"At least with drugs the economics are relatively straightforward, with precision radiotherapy the issues are more complex and so far hidden from the political media limelight," said Professor Sikora.
"There are 61 radiotherapy centres in the UK. Of these, 28 now have equipment to provide intensity modulated radiotherapy, which is now standard in the US and most of Western Europe. However, only three British centres routinely provide this radiotherapy to significant numbers of patients: Clatterbridge in Liverpool, Ipswich and the Royal Marsden in London.
"Furthermore, delays abound with a three-month waiting time for radiotherapy being common in the UK. In contrast, a centre in Zurich currently has a working group engaged in re-engineering the time from first contact to radiotherapy delivery from five to three working days.
"Despite the £90 billion being spent in the NHS in 2007, which will rise to an expected £108 billion next year, UK service provision and technology still lagged behind its European neighbours."
Professor Sikora said UK needed an urgent political debate about paying for cancer care.
"How much we are willing to pay for an extra year of good quality life with cancer is going to be a key question for the baby boomer generation," he said.
"Consumerism and social solidarity do not sit comfortably together. A recent survey by the information charity Cancerbackup showed that 67 per cent will vote in the next election on the basis of health policy and for 76 per cent of us cancer is the most important health issue.
"No politician can afford to ignore these statistics. The UK needs to have an urgent debate about whether the NHS should be able to provide, not just a core package of services, but also allow patients to contribute financially for improved services for themselves," Professor Sikora said.
Professor Karol Sikora is Medical Director of CancerPartnersUK which is creating the largest UK cancer network as a series of joint ventures with NHS Trusts. He was Professor of Cancer Medicine and honorary Consultant Oncologist at Imperial College School of Medicine, Hammersmith Hospital, London. He has published over 300 papers and written or edited 20 books including Treatment of Cancer - the standard British postgraduate textbook now going to its fifth edition and most recently The Economics of Cancer Care.
'Paying for cancer care - a new dilemma' is published in the April 2007 issue (Vol. 100) of the Journal of the Royal Society of Medicine (JRSM) , the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi. http://www.jrsm.org
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