Cancer patients can still access NICE rejected drugs

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Anti cancer drugs that have been rejected by the UK Government’s new cancer drugs fund would still be available to needy patients according to the new ‘top-up’ cash plan that is being launched. This Health Top-Up cash plan comes from Western Provident Association (WPA).

This plan will pay out £50,000 towards expensive, life-prolonging drugs not available on the NHS. The private medical insurances will also cover for these drugs but premiums are expensive. These cash plans are much cheaper but they do not provide full insurance. One of the drugs rejected by the National Institute for Health and Clinical Excellence (NICE) is Avastin, which costs £18,000 for a ten-month course of treatment for bowel cancer.

Cancer doctors can apply to the fund when they believe patients can benefit from a drug that has been rejected for routine use by the NICE. Under the new plan up to five children can be included on their parent’s plan for free. Cover for cancer can be added for an extra £4.20 a month, providing a lifetime limit of £50,000 to pay for drugs. The scheme covers people aged up to 65 who have no history of cancer in their immediate family. Premiums for smokers are higher at £10 a month for the cancer drugs add-on.

According to Mike Izzard, of Premier Choice Healthcare, “Several medical insurers are looking to develop a stand-alone cash plan for cancer like the one offered by WPA, but so far no one has brought one out.” Julian Stainton, chief executive of WPA said, “There is going to be enormous pressure on the new cancer drugs fund, not least from colon cancer patients needing Avastin. There may not be enough money to go round. We step in where the drug is recommended by an oncologist, but is not readily available on the NHS.” Cancer specialist Professor Karol Sikora says many patients are not getting new drugs routinely used in other European countries because of NHS rationing.

Defending NHS decisions health economist at the University of York, Professor Mark Sculpher said, “It’s fiendishly complicated. It’s politically fraught. But NICE has developed processes and methods which have worked very well. The process is very transparent and explicit. However, when they say at this price this drug is simply too expensive for the NHS, there’s often all sorts of poorly conceived media coverage about the decisions.”

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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