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UK lagging behind on
cancer drug access, study finds
by staff writer, May 10, 2007 Guardian Unlimited




Cancer patients face "stark inequalities" in access to treatment globally, with the UK lagging behind other western countries in its use of new drugs and survival rates, a report said today.

The study found that uptake of new cancer drugs is "low and slow" in the UK, as well as in New Zealand, Poland, Czech Republic and South Africa. Austria, France, Switzerland and the US were leaders in using new cancer drugs.

The study, published in cancer journal Annals of Oncology, was compiled by Dr Nils Wilking, clinical oncologist at the Karolinska Institute in Stockholm, Sweden, and Dr Bengt Jonsson, director of the Centre for Health Economics at the Stockholm School of Economics.

The researchers surveyed Australia, Canada, New Zealand, Japan, South Africa and the US, as well as 19 European countries, with a total population of 984 million, looking at access to 67 innovative cancer drugs.

They found differences in access reflected in patient outcome in the five major western European countries - France, Germany, Italy, Spain and the UK.

France had the highest five-year survival rate for all cancers apart from non-melanoma skin cancer - 71% for women and 53% for men. The UK had the lowest at 53% and 43% respectively.

In France, Spain, Germany and Italy, 51-52% of cancer patients were treated with drugs launched after 1985. But only 40% of patients in the UK had access to these drugs.

Dr Jonsson said: "Around one sixth of the differences between these five countries in five-year cancer survival is due to differences in the uptake of new drugs in each country."

The report also highlights an imbalance in public investments in cancer research between Europe and the US.

Dr Jonsson said: "Not only is the magnitude of public research at a different level in the United States, it is also directed to clinical research to a greater extent. There is a need for a significant increase in the public research for cancer in Europe, particularly devoted to clinical research."

Generally, the greatest differences in uptake were noted for the new colorectal and lung cancer drugs, which are among the world's top cancer killers for both men and women. The US uptake of bevacizumab for colorectal cancer was 10 times the uptake of the European average, with the UK having a very low uptake.

Dr Jonsson concluded: "We believe that the inequalities between countries in patients' access to cancer drugs cannot persist. Cancer patients will not accept that a standard of care available in one country is not available in other countries."

The report's recommendations included reducing the review time for the marketing authorisation of new cancer drugs and ensuring that, once this is obtained, the drug is available without further delays.

A Department of Health spokesman said: "We are making good progress in ensuring cancer patients have access to the drugs they need. A report published by the national cancer director last year confirmed a continued increase in the uptake of new cancer drugs by the NHS following positive Nice appraisal.

"It also confirmed a reduction in the variation of use of these drugs around the country. We have reiterated in recent guidance that NHS should not withhold funding for treatments just because Nice guidance is not available."



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