Cancer Treatment

red11

red11

red11

Soldato
Joined
12 Jun 2005
Posts
8,395
I am quite shocked that a lot of hospitals can refuse treatment for breast cancer using the drug Herceptin. I'm sure a lot of you have heard about the story currently on the news about the woman who has been denied this new drug to help with her battle against breast cancer, link below:

http://news.bbc.co.uk/1/hi/health/4677086.stm

Is this what it's going to be like when an 'actual' cure for cancer is found or created, that only a select few will be able to use it? The government should be getting behind this drug and helping more with production. What do you guys and gals think? I think it's unacceptable as they are putting prices on peoples lives. :(
 
Anyone who needs it should have it, and thats all there is to it imho. These people who need it pay their National insurance al their lives, for them to be turned away in their hour of need because the drug is too expensive is sickening. How can you put a price on human life? If need be raise the NI payments, or take money from less essential departments Like the immigration budget etc.
 
Unfortunately this situation is going to keep cropping up for a long time now. I'm actually revising a couple of modules in Pharmacology and one of them is the regulatory framework of developing and submitting dossiers for new drugs and it's not an easy process. I do feel for the woman but as it says in the article, Herceptin isn't licenced for use in early stage breast cancer so she's not eligable for that. Rules like that aren't put there purely as a cost saving measure, there are complex risk-benefit assessments that go on behing the scenes and licencing is so strict on medicines these days that it would be economical suicide for the drug company and NHS trust to break any of the rules the EU/UK set.
It is highly immoral to be putting a price on someone's life but if you look at the whole picture, the NHS only has a certain budget and if they spend it all on one expensive treatment (over simplification I know) they won't have much left for others. To be honest, £20,000 is probably (EDIT: definitely) wasted in beurocracy in the NHS but even so, there isn't unlimited money to go round.
I'm not trying to defend the NHS's decision to withhold thie drug but just add a few facts before people start slagging them off for being monsters
 
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Arpegius said:
Unfortunately this situation is going to keep cropping up for a long time now. I'm actually revising a couple of modules in Pharmacology and one of them is the regulatory framework of developing and submitting dossiers for new drugs and it's not an easy process. I do feel for the woman but as it says in the article, Herceptin isn't licenced for use in early stage breast cancer so she's not eligable for that. Rules like that aren't put there purely as a cost saving measure, there are complex risk-benefit assessments that go on behing the scenes and licencing is so strict on medicines these days that it would be economical suicide for the drug company and NHS trust to break any of the rules the EU/UK set.
It is highly immoral to be putting a price on someone's life but if you look at the whole picture, the NHS only has a certain budget and if they spend it all on one expensive treatment (over simplification I know) they won't have much left for others. To be honest, £20,000 is probably (EDIT: definitely) wasted in beurocracy in the NHS but even so, there isn't unlimited money to go round.
I'm not trying to defend the NHS's decision to withhold thie drug but just add a few facts before people start slagging them off for being monsters
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I can see exactly what your saying, which is why I said I would be happy for my monthy NI payments to go up to cover this, I know if one of my loved ones had cancer I'd he happy to pay as much as could to make sure they had the best treatment, as would anyone. Or additional funding to be made available from less essential services
 
As Arpegius says Herceptin is not licensed for use in early-stage breast cancer, as there is little evidence to support its effectiveness in such cases - and certainly enough to warrant its use ahead of tamoxifen and other established treatments.

The few trials that I am aware of, although exibiting encouraging results, are limited by many factors, not least timescale (with follow up of only 1 year so far). I think that, as with any other treatment the healthcare trusts should be free to decide whether or not they can provide certain healthcare delivery, as long as they stay within the best prctice guidelines set out by the MoH and NICE.

If, and only if, the government wish to provide extra funds for people to have these expensive, unproven treatments then I am all for it. But the trusts should not be forced into diverting funds from other areas to fund this, especially at a time when the majority of trusts are struggling with severe budget defecits and being threatened by the government over this if they do not implement cost-saving measures :rolleyes: Its just another case of this government tying the NHS's hands, then hanging it out to dry when it inevitabley fails.
 
Just to back up the NHS in cases like this, the woman may have been paying NI all her life, but i just calculated my NI payments for 40 years, and it came up to £90,000, nowhere near the £200,000 that this drug costs.

Unfortunately thats the way the world goes, the NHS doesn't have enough money to buy everything for everybody.

The more people win these cases for a drug that only INDICATES that it may help early stages of breast cancer, the less money there is to go to people who need geniune established treatment. You'd be livid if your hospital couldn't treat something because they spent all their money on an unproven drug for other people.

Flame away...
 
chimaera said:
Just to back up the NHS in cases like this, the woman may have been paying NI all her life, but i just calculated my NI payments for 40 years, and it came up to £90,000, nowhere near the £200,000 that this drug costs.

Unfortunately thats the way the world goes, the NHS doesn't have enough money to buy everything for everybody.

The more people win these cases for a drug that only INDICATES that it may help early stages of breast cancer, the less money there is to go to people who need geniune established treatment. You'd be livid if your hospital couldn't treat something because they spent all their money on an unproven drug for other people.

Flame away...
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£200,000? It's £20,000 for a years treatment, do they expect her to be taking it for 10 years?
 
chimaera said:
Just to back up the NHS in cases like this, the woman may have been paying NI all her life, but i just calculated my NI payments for 40 years, and it came up to £90,000, nowhere near the £200,000 that this drug costs.
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So lots of people dont pay a penny into the sytem and get lots of free expemsive treatment, they should be the ones turned away. :(
 
Cuchulain said:
£200,000? It's £20,000 for a years treatment, do they expect her to be taking it for 10 years?
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£20,000 pa is a bit of an underestimate by the BBC. The manufacturer states that the cost of combination herceptin treatment will be £37,500 per Quality Adjusted Life Year (QALY - ie amount of time AND quality of life gained by treatment, which is the standard measure for evaluating cost effectiveness of treatment). Also, projescted costs for actual life years saved are around £26,000-30,000 pa.
 
Cuchulain said:
I want to know why a years treatment costs 20 grand, I know Roche probably need their research funding but surely it costs pennies to produce these things?
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It's actually quite an expensive process as I understand it because it uses immunomodulation, so it isn't just a case of mixing chemicals. Admittedly it won't cost the £400 per vial that Roche are charging, but they have a monopoly and aren't a charity, so they shouldn't really be criticised, they have to recoup research costs somehow.
 
Cuchulain said:
£200,000? It's £20,000 for a years treatment, do they expect her to be taking it for 10 years?
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Ok my mistake "the remainder of the full course could cost up to £40,000 " thats still a hefty chunk of money, more than most people will claim off the NHS in their lifetime. Bearing in mind my local NHS trust is holding funraisers for a £50,000 advanced brain scanner, it puts it in perspective. I'm not saying she shouldn't get it, just that i can understand why the NHS is reluctant, if every woman who gets brest cancer requests this treatment it would bankrupt the NHS.

So lots of people dont pay a penny into the sytem and get lots of free expemsive treatment, they should be the ones turned away.
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Unfortunately thats sometimes the way. Personally i think the NHS needs re-structuring, smokers, heavy drinkers and those who constantly live a bad lifestyle with no desire to change should be charged more.
 
You also have to remember that the research costs for drugs is HUGE.

For every successful drug that is found there are hundreds that are unsuccessful. Doing clinical trials alone will cost a drug company millions of pounds.

This cost all has to be made back quickly due to the drug licensing laws. As it stands IIRC patents only last for 10 years, take off the time it takes for clinical trials...etc and it doesnt leave very many years to make back a staggering amount of money.

After this time, other drug companies are able to offer the drug aswell, creating competition and lower prices.

Would you commit 500million to a drug development to bring it to the market and then leave the price low so you only made 100million back? The limited source of production and ridiculous research costs dictate the prices the NHS has to pay

Currently i dont think there is any evidence that Herceptin treatment is better than other available treatment in early stages. With evidence based medicine you have to rely on trials for what you will treat people with.
 
chimaera said:
Unfortunately thats sometimes the way. Personally i think the NHS needs re-structuring, smokers, heavy drinkers and those who constantly live a bad lifestyle with no desire to change should be charged more.
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As an ex-smoker, you do know that in my lifetime I've probably pumped at least twice the amount of funds into the NHS through taxation on cigarettes than your average non-smoker right? Duty on cigarettes and alcohol more than compensates for the amount of treatment people who drink and smoke require, if you feel strongly enough about them paying extra for medical treatment then perhaps you should lobby Gordon Brown into drastically lowering the duty.
 
Cuchulain said:
As an ex-smoker, you do know that in my lifetime I've probably pumped at least twice the amount of funds into the NHS through taxation on cigarettes than your average non-smoker right? Duty on cigarettes and alcohol more than compensates for the amount of treatment people who drink and smoke require, if you feel strongly enough about them paying extra for medical treatment then perhaps you should lobby Gordon Brown into drastically lowering the duty.
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Ah yes but you see when i'm Overlord of the world and introduce this rule you'd be exempt, as you have made an effort to stop smoking, its only those like George Best who just keep taking from the system and don't make much of an effort to change.

Personally i'd raise the duty on cigs even higher :p considering they are a luxury and one that also damages your health. I think its disgraceful how this government uses them as a cash cow, similarly to speed cameras. Up the duty to make it too expensive for people to smoke, thereby reducing the stress on the NHS for smoking related illnesses, which would mean that the reduction in duty from people buying cigs will not matter.

Simple this politics malarky really ;)
 
Cuchulain said:
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Besides which, the greatest thing about the NHS, and one of its founding principles is that it is free at point of use - and everyone can expect a similar level of treatment, irrespective of who they are.

In fact, lets apply what you are saying to Herceptin for instance. Do you think that every woman should be tested at birth for the HER2 gene (which Herceptin targets for its effect), and every woman who has it has to pay a premium rate of tax. And why stop there, why not assess everyone for their relative risk and projected NHS expenditure on them, and tax them appropriately?? Hardly the kind of thing I can see catching on
 
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chimaera said:
Up the duty to make it too expensive for people to smoke, thereby reducing the stress on the NHS for smoking related illnesses, which would mean that the reduction in duty from people buying cigs will not matter.
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That would not work for 2 reasons. Firstly the NHS (and government) gets a far higher amount in income from taxation of smokers than it spends on smoking-related illnesses. Secondly, it would encourage a black market (which even at current duty rates is claimed to be responsible for £3m in lost tax), which would provide the cigarettes and related health issues, but with non of the tax revenue
 
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