Britain's NHS Denies Care for Patients Paying Privately for Drugs

Britain's NHS Denies Care for Patients Paying Privately for Drugs
August 1, 2008

Rina Shah

Rina Shah writes from Washington, DC. (read full bio)

British taxpayers suffering from life-threatening diseases are being denied many of the latest and most effective drugs because of a government policy disallowing co-funding with private companies.

An investigation conducted by The Sunday Times found Britain's taxpayer-funded, government-run National Health Service (NHS) is providing some of the sickest patients with medications that are known to be as low as one-fifth as effective as alternatives.

The investigation also found NHS has invoked a policy of refusing care altogether to patients who, often upon physician recommendation, choose to pay out-of-pocket for best-available drug treatments.

Can't Use Lifesaving Drugs

Many new, privately available drugs are potential lifesavers but are de facto prohibited by Britain's slow-changing government monopoly health care bureaucracy.

One such drug is Sutent, a medication prescribed to kidney patients, which costs £2,200 per month (about $4,300). The NHS-approved drug for the same condition, alpha interferon, costs about £800 (almost $1,600). Clinical studies have shown Sutent extends the lives of kidney patients at least six months longer than alpha interferon.

Despite this proven effectiveness, NHS has refused to approve Sutent for distribution to NHS patients and is denying all taxpayer-funded care to patients who purchase the more-effective drug with their own money.

Unnecessary Cancer Deaths

Similarly, in treating bowel cancer, patients in other European countries such as France, Germany, and Spain are between nine and 13 times more likely than their British counterparts to receive Erbitux. Tumor shrinkage is four times more likely with this drug than with irinotecan, the NHS-approved drug. Erbitux controls bowel cancer for twice as long as the standard NHS therapy, making its price tag of £3,000 a month more than "worth it" for some patients.

Prof. Mike Richards, Britain's National Cancer Director, acknowledged NHS spends half as much on cancer drugs as some other European countries, citing 2004 figures showing the British government spent £76 per person per year, compared with £121 in France and £143 in Germany.

Britain's cancer survival rates are the lowest among its major Western European neighbors.

'Perverse, Vindictive' Policy

Leading UK physicians have voiced their concerns over the refusal to make highly effective drug therapies such as Sutent and Erbitux available to patients who need them most. Physicians also protest, on ethical grounds, the government's prohibition on NHS patients paying for these additional drugs.

A source at NHS, who spoke on condition of anonymity, said it seems "perverse and vindictive" to withdraw all care from a patient who "seeks to prolong their life while doing what is necessary to bridge costs."

"Denying individuals the ability to make health and life decisions because of the perception of an unequal playing field is the height of perversity and is a great example of just why a government, instead of the individual patient, is so unsuited for the task of making medical decisions," said Jeff Emanuel, research fellow for health care policy at The Heartland Institute and managing editor of Health Care News.

Some physicians have simply ignored the ban and have continued administering care in NHS facilities to patients who pay for the recommended drugs. They are implementing, in effect, an illegal form of co-payment in a nation whose health care system is ostensibly 100 percent taxpayer-funded and government-directed.

Citizens Prefer Choice

Supporters of the ban fear allowing co-payment will tilt the medical playing field toward the wealthy and will upset less well-off patients. Health Secretary Alan Johnson's greatest concern has been to avoid allowing patients to create a "two-tier NHS"--one offering the government-approved minimums of drugs and care, and another providing some treatment while wealthy patients import expensive supplements to NHS offerings.

A recent poll conducted by The Sunday Times, however, found only 5 percent of Britons believe allowing co-payments would create a two-tier NHS. The same poll showed an overwhelming 89 percent of people believe those who buy additional cancer drugs should continue to get free NHS treatment.


Rina Shah (rshah38@gmail.com) writes from Washington, DC.


For more information ... "Banned cancer drugs better than NHS ones," The Sunday Times, June 15, 2008: http://www.timesonline.co.uk/tol/life_and_style/health/article4138237.ece

Rina Shah

Rina Shah writes from Washington, DC. (read full bio)