Speaking in the Scottish Conservatives Debate on Health, Dr Nanette Milne, Scottish Conservative MSP for the North East and Member of the Scottish Parliaments Health Committee has called on the SNP Scottish Government to make a North East man’s fight for cancer drugs accessibility a reality.
Dr Nanette Milne, Scottish Conservative MSP for the North East and Member of the Scottish Parliaments Health Committee said:
“I was a member of the Public Petitions Committee in 2008 when Mike Gray from my Region presented a petition to Parliament whilst suffering from terminal bowel cancer which was being treated by the non-formulary drug cetuximab. He had initially paid for this drug himself after his consultant’s request for it under the Exceptional Prescribing Procedure had been turned down by NHS Grampian.
“Mr Gray had found the procedure obscure and difficult to navigate, and in his state of health this was extremely stressful and upsetting. He brought the petition to Parliament to try and ensure that a better process would be put in place for future patients, so that they would not have to undergo the traumas of his own experience.
“In the end Mr Gray was allowed his cetuximab under the NHS, and indeed was reimbursed for the significant costs he had previously faced up to personally. Sadly he did not live to see the results of his petition, but his wife Tina McGeever worked tirelessly alongside the Committee to secure the new IPTR procedure put in place by the then Health Secretary to make it easier for patients to access modern non-formulary cancer drugs, recommended by their clinicians as likely to extend and to benefit their quality of life; and everyone was hopeful that future cancer patients would experience a simplified, transparent procedure across Scotland to allow fair access to modern cancer medicines when their clinicians felt they were justified.
“However, despite three CMO guidance documents issued to Health Boards in as many years, there is as yet no significant evidence to suggest an improvement in access, or even a significantly reduced level of inequality between Health Boards regarding the implementation of the IPTR process, and I know that Tina McGeever and many of us here were very concerned to learn that Christine Grahame’s constituent Ian Morrison is currently having a very similar experience to Mike Gray, and is having to fund cetuximab treatment himself. So the review of the IPTR process set up by the Cabinet Secretary is very welcome.
“In the meantime a fund such as the Cancer Drugs Fund, established in England, but refused in Scotland on the grounds that it would be discriminatory against non-cancer patients, could have helped over 2000 Scottish patients so far. And whilst of course we welcome the Rare Conditions Medicines Fund, this will clearly not benefit patients like Ian Morrison, and it is awful to think that patients unfortunate enough to develop their cancer in Scotland are not getting some of the new drugs which are now available in England and elsewhere.
“Moreover, as pointed out by oncologists giving evidence recently to the Health & Sport Committee, because patients here do not have access to these medicines, they will not get the next generation state of the art drugs when these undergo clinical trial, because the new drugs will be judged against those which are currently not approved or available in Scotland, but regarded as standard therapies elsewhere in the UK.
“Already this is leading to some difficulty in recruiting expert staff in our hospitals, and it could result in a drift of experience from Scotland. If this happens we could soon lose our position as a leader in cutting edge medical research.
“No-one disagrees that new drugs require assessment, or that the SMC does this with a high degree of expertise and professionalism, but current assessment methods have been shown to disadvantage some disease areas, and hopefully the current Routledge review will result in further evolution of currently used methods to allow a wider assessment of a medicine’s value.
“The Cancer Drugs Fund in England and the proposed Rare Conditions Medicines Fund in Scotland are intended to bridge the gap until Value Based Pricing is introduced next year. But we must remember that the new pricing mechanism will apply only to drugs which come on stream after its introduction, and cancer patients who need currently available non-formulary drugs will still lose out unless some form of funding is put in place for them to gain access to these medicines.
“I feel strongly that there needs to be an appropriate means of funding drugs which are not routinely available, but which are judged by clinical experts to be an appropriate and necessary part of their patients’ treatment, and that patients across Scotland should have a clear and equitable pathway to accessing such recommended medicines.”