NHS restrictions on cancer drug due to be lifted

Health Editor,Jeremy Laurance
Wednesday 12 April 2000 00:00 BST
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Two expensive cancer drugs for women, which have been at the centre of "rationing by postcode" allegations, are due to be recommended for use throughout the NHS.

Two expensive cancer drugs for women, which have been at the centre of "rationing by postcode" allegations, are due to be recommended for use throughout the NHS.

The National Institute for Clinical Excellence (Nice), the Government's watchdog on new treatments, is expected to issue guidance in the next few weeks on the use of Taxol and Taxotere for patients with ovarian and breast cancer, and is due to give the go-ahead for their general use.

However, one of the companies involved is unhappy with the guidance and has appealed. The appeal is expected to be heard in the next few days

The two drugs have been prescribed to some women but not to others depending on whether their health authority agreed to fund the cost. In some cases this has meant patients living on opposite sides of the street but in different postcode areas being treated differently.

Ministers have hinted for months that the drugs would be recommended for wider use once Nice had examined the evidence, apparently pre-empting its decision.

Yesterday a leaked report to the BBC suggested Nice had made its decision which had angered one of the companies, prompting an appeal.

Nice is understood to have recommended that Taxol, made by Bristol Myers Squibb, has proved its worth in patients with advanced ovarian cancer and should not be restricted. The drug costs £6,000 to £7,000 for a course and at least five health authorities do not fund it for any patients. Trials have shown that it extends life by 13 months, twice the average survival period without the drug.

However, Nice is understood to have refused to recommend Taxol in advanced breast cancer, for which the drug is also licensed, despite evidence showing a 25 per cent improvement in survival. This is to be the subject of an appeal by Bristol Myers Squibb.

Taxotere, made by Aventis, is also expected to be recommended for women with advanced breast cancer after trials have shown it is effective in one-third to one-half of patients. The drug costs £4,600 for an average four courses but only a quarter of the 4,000 women who could benefit currently receive it.

The health department, Nice and the two drug companies were all tight-lipped yesterday, insisting they could not comment until the guidance was published. Doctors and patients, however, declared the argument won.

Gordon McVie, the director general of the Cancer Research Campaign, said health authorities had used the cost of the drugs as an excuse not to prescribe them for too long. "They are running out of excuses now. We are expecting any day some sort of papal announcement from Nice that what is happening in the rest of the world can be allowed to happen in Britain too.

"These drugs are not new. When I tell my friends in the US that I'm very excited because we're going to get Taxol and Taxotere, they look at me as if I've just crept out of a time warp."

Jackie O'Donnell, 55, from Middlesbrough, who was diagnosed with ovarian cancer in1998, said: "After my hysterectomy I was told that I could not be treated with Taxol. If I had lived just two miles away, I could have had it because the health authority in North Yorkshire did pay for it. I didn't believe the postcode lottery existed until it happened to me." After a long campaign Mrs O'Donnell changed the policy of the health authority and was given the drug. She has since remained well.

Tony Blair, who was opening a walk-in medical centre in Peterborough yesterday, said if Nice recommended the two drugs, funds would be made available to pay for them. He said: "It is precisely for these kind of treatments that we have put extra money into the health service. For the first time in 50 years we have got a system of evaluation which allows us to assess whether these drugs work or not."

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