If we want cancer survival rates that compare with the best in the world, we can't rely on political quick fixes.
If we want cancer survival rates that compare with the best in the world, we can’t rely on political quick fixes
Cancer is an illness that has a unique hold over the public imagination. This dreaded condition is feared like no other disease. A diagnosis of cancer, even when the prognosis is good, is an enormous shock to the individual affected, as well as their family, friends and colleagues.
Finding out that I had bowel cancer in 2008 left me disorientated and tearful for weeks. It is the terror and emotion attached to cancer that provokes ill-considered policy responses from politicians to treating it.
The Cancer Drugs Fund is one example of political quick fix that is designed to assuage public opinion. And the coverage attached to yesterday’s news that three drugs for common forms of cancer may be excluded from this fund is so emotive that it obscures all considered discussion about healthcare funding.
The Cancer Drug Fund is a coalition government initiative. It covers England and was started in April 2011, implementing a Conservative Manifesto commitment. Specifically, it funds drugs that have been rejected by the National Institute for Health and Care Excellence (NICE) as being cost effective forms of treatment.
The medicines for most cancer patients will not be funded by the Cancer Drug Fund – my two chemotherapy drugs were not. Typically, the drugs it funds are expensive and may only extend life by a few months. Kadcyla, a breast cancer drug covered by the Fund, costs £90,000 a course but may only extend life by six months.
Between 2011 and 2014, the Cancer Drug Fund had an annual budget of £200 million, although it overspent. Last year an extra £160 million was allocated to the fund, takings its annual spend to £280 up to March 2016. But despite extra money, it has again gone over budget.
Financial pressures led to the government reviewing the drugs covered by the Fund last November, with 42 drugs put up for review. Yesterday’s announcement is also a likely response to budgetary pressures.
Predictably, these announcement have been met with an outcry from cancer charities.
Since 2011 the Cancer Drugs Fund has treated about 55,000 people, although this is a small proportion of those living with cancer. Excluding non-melanoma skins cancer there are over 300,000 new diagnosis of cancer every year in the UK, with breast, ling, colorectal and prostate cancers accounting for the largest proportion of new diagnosis. On wednesday Macmillan estimated that there were 2.5 million people living with cancer in the UK.
For the government the fund is also a public relations triumph as it prevents negative media stories – those where deserving cancer patients tells of heartless decisions to deny them life-extending drugs.
But there have been criticisms of the Cancer Drug Fund. Other potentially life-threatening conditions are not covered by their own equivalent funds – because such conditions lack the fear factor attached to cancer.
There have also been suggestions that the Fund encourages price inflation and profiteering by drug companies.
Money allocated to the budget ends in March 2016. But the nature of the debate about cancer means that the next government would find it difficult to end the fund. As such, the fund pushes into the long grass any serious debate about the long-term funding of expensive healthcare interventions.
As technology advances and as we age, this is a challenge facing all countries. Now, and after the next election, we need a serious debate about NHS funding, encompassing issues such as how much we are prepared to pay and issues such as hypothecated taxation.
If we want to achieve the cancer survival rates that are comparable with the best in the world, we do not need political quick fixes, rather, democratic debate about funding and healthcare practices that are informed by evidence.
Jill Rutter is a contributing editor to Left Foot Forward
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