Recent steps by the Health Secretary, Andrew Lansley, to establish a 'Cancer Drugs Fund', which bypasses the National Institute for Health and Clinical Excellence (NICE), establishes a mechanism to pay for drugs that some GPs and patients may have wanted, but which may have been viewed by NICE as too expensive for the NHS.
With a temporary fund set aside by central government until March 2011 and hundreds of millions of pounds a year following, some clinicians have already publicly questioned the morality of establishing a fund specifically for cancer, asking 'why only cancer?' and not multiple sclerosis, muscular dystrophy, epilepsy or one of many, many more chronic conditions.
Clinicians and commentators have voiced other potential complications too. What happens if one patient is provided with a monoclonal antibody like Avastin and there's no money left to pay for an anti-androgen (to treat prostate cancer) like Casodex? What happens if someone who needs treatment early in the financial year has funds provided, whereas someone else presenting towards the end of a financial year is denied treatment because the money has already been spent? It's a moral minefield, to say the least.
Although many agree NICE may not have been a perfect system for allocating NHS resources, it's drug funding approval process could easily be viewed as more equitable than a potentially arbitrary decision about the timing of a request for funding, rather than the relative merits of individual drug therapies. There's a risk of a fair amount of confusion about which drugs can be provided and when, so we'd suggest seeking guidance from your benefits or specialist healthcare advisors at the earliest opportunity if you need to clarify any implications for your business (particularly any private medical insurance schemes).
Alongside the changes to funding cancer drugs come other significant changes to the NHS, particularly with regard to commissioning health services. The disbanding of strategic health authorities and primary care trusts (PCTs) means that NHS services will be commissioned through new 'GP consortia'.