New cancer drugs held up by the NHS for nine years as rationing body accused of letting down patients

Rationing body NICE is denying potentially life saving drugs because it is bogged down in other tasks, doctors claim
Delays can make the difference between someone being able to live independently or needing full time care
Some treatments for Alzheimer's, arthritis and hepatitis C delayed for more than a decade on average

By Sophie Borland

PUBLISHED: 17:20 EST, 15 May 2012 | UPDATED: 17:45 EST, 15 May 2012

UK Daily Mail:

Approval: People with Alzheimer's have been left waiting for years to receive new drugs on the NHS it is claimed because the rationing body is bogged down in other tasks

Patients are waiting up to nine years for cancer and Alzheimer’s drugs to be available on the health service because approval takes so long.

The delays mean that even new drugs given the all-clear in extensive trials remain stuck in the queue for years.

A major study found that on average it takes five years from a treatment’s launch by a manufacturer to approval by the rationing body, NICE.

But the process often lasts far longer, and on occasions NICE will not even start its assessment until a drug has been on the market for more than a year.

One of the problems is that NICE – the National Institute for Health and Clinical Excellence – has a wide-ranging remit which includes drawing up NHS guidance on tackling obesity, alcohol abuse and other public health issues.

But last night doctors and charities said it was unfair that patients were being denied potentially life-saving drugs just because the rationing body is bogged down in other tasks.

They said the delays are affecting patients’ quality of life and could make the difference between someone being able to live independently or needing full-time care.

Although patients can get drugs that have not yet been approved by NICE by paying privately or applying to the Cancer Drugs Fund, doctors are often reluctant to prescribe them.

The report by the Office for Health Economics, obtained by GP Newspaper, looked at all the drugs approved by NICE since 2000, covering a total of nearly 300 treatments including those for cancer, Alzheimer’s disease, and heart problems.

When making its decisions, NICE classifies drugs into two groups. Those which would be used on their own undergo ‘single’ appraisals, while those which are taken with another drug are subject to ‘multiple’ appraisals. These take several years longer.

Delays: A major study found that on average it takes the NHS rationing body NICE five years to give approval to a treatment after its launch

In 2010, the most recent year for which figures are available, the average delay for the 11 drugs which were approved after multiple appraisals was 10.2 years.

They included treatments for arthritis, hepatitis C and Crohn’s disease, a debilitating bowel disorder.

The average delay for multiple drugs given the green light in 2005 was 8.7 years. They included treatments for bowel cancer (irinotecan and oxaliplatin) and cancer of the womb (topotecan and pacilitaxel).

In 2006 NICE approved three Alzheimer’s drugs, Aricept, Reminyl and Exelon, although only for patients in the ‘moderate’ stages of the disease.

These treatments would have been classified as multiple appraisals, and that year the average time these assessments had taken was 7.8 years.

Delays: Patients can get drugs that have not yet been approved by NICE by paying privately or applying to the Cancer Drugs Fund, but doctors are often reluctant to approve them

Last night Andrew Chidgey of the Alzheimer’s Society said: ‘People with all types of dementia desperately need effective treatments to live a better quality of life and stay independent for longer.

‘Five years is a long time to wait. Whenever a new drug is available, NICE guidance should be issued as quickly as possible.’

Heather Walker of Cancer Research UK said patients needed effective drugs ‘swiftly’ and added: ‘There needs to be a balance between giving NICE enough time to make the right decisions and ensuring that drugs get to patients as soon as possible.’

Dr Anita Sharma, a senior GP in Manchester, said: ‘Being too busy to appraise a drug is not acceptable.’

NICE’s role includes drawing up public health guidelines such as how NHS trusts should tackle obesity. It also sets ‘quality standards’ which state how patients with a range of illnesses should best be treated.

Earlier this year the watchdog took on yet another role and began drawing up guidelines on social care. It will shortly be issuing advice on how NHS staff should care for the elderly with dementia and vulnerable children.

A spokesman from NICE said: ‘We don’t recognise most of the conclusions reached by the Office for Health Economics report which was published in January this year.

‘The report includes in its average figures some drugs that received their licences many years before NICE was established in 1999.

‘NICE has since been asked to appraise such drugs, but their inclusion in this report has skewed the average length of time elapsed from marketing authorisation to published NICE guidance quite considerably.’