Survey adds pressure for re-think on bowel cancer drugs
pharmafile | March 24, 2009 | News story | Medical Communications, Sales and Marketing | Cancer
A new survey by Beating Bowel Cancer has highlighted the problems facing patients with the condition in getting the best treatment and advice.
The poll suggests cancer patients might not be getting the full picture on treatment options because doctors feel uncomfortable discussing cost.
The charity also found that oncologists think a third of patients would benefit from treatments not currently approved by NICE.
The research is part of a campaign called Ethical Dilemmas, which is supported by both Roche and Merck Serono and run by the charity.
The survey clearly aims to add weight to calls for a re-think on the use of new drugs to treat the condition.
Merck's Erbitux, Roche's Avastin and Amgen's Vectibix are three new targeted treatments for bowel cancer, but are not generally available on the NHS.
Avastin and Erbitux were both rejected by NICE in February 2007.
Vectibix has not yet been assessed by NICE, but was rejected for use in Wales by the All Wales Medicines Strategy group in February this year.
NICE-approved treatments for the disease include Roche's Xeloda as well as Sanofi-Aventis' Eloxatin and Bristol-Myers Squibb's Uftoral.
The charity says three out of four oncologists want clearer guidance on how to talk to patients about non-NHS funded treatment.
The government's recent green light to top-up treatment has brought the issue into sharp relief, said Dr Mark Saunders, consultant clinical oncologist at the Christie Hospital NHS Foundation Trust in Manchester.
Broaching the issue of accessing drugs not routinely available on the NHS is "sensitive" and Saunders said medical professionals needed a "clearer steer" on the matter.
"As a doctor often faced with patients who simply could not afford to pay for treatment if their PCT refused to fund a drug, I regularly have to face the dilemma of how and when to start the difficult discussion about accessing such treatment," he added.
Four out of five consultants also described the level of support on how to talk about unfunded treatment as "inadequate".
Other survey highlights included:
* Around 60% of respondents thought it should be a hospital manager's role to discuss the cost of treatment
* Consultants admit that half their patients would welcome a frank discussion of all treatment options
* Nearly all respondents mention treatment options for which they may not be able to secure funding, with 20% doing so "often"
* One third of oncologists have at times been told by their PCT not to apply for exceptional funding
Hilary Whittaker, chief executive of Beating Bowel Cancer, said the NHS needs to review its system "so that oncologists are given proper guidance and support".
The charity wants the government to increase the length of appointment times, provide more NHS training, ensure national guidance is implemented and put in place local protocols.
Bowel cancer is the second largest cause of cancer deaths in the UK and the third most common cancer in the UK after breast and lung cancers.
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