When a drug for cancer is not available as an NHS treatment

When a drug for cancer is not available as an NHS treatment

Guidance to patients when a drug for Cancer is not available as an NHS treatment

Your consultant is aware of a treatment that might be of benefit to you, but this drug is not currently available as an NHS treatment at this hospital.

Approval for drugs is provided by the Primary Care Trusts, but this depends upon guidance from the National Institute for Health and Clinical Excellence ( NICE). NICE recommends how different drugs for cancer can be used once they have been licensed to treat patients with a particular type of cancer. They base their guidance on the cost-effectiveness of the drug, taking into account the cost of treatment and the likely benefits to a group of patients who receive it at a specific stage in their illness. The introduction of new treatments has to be carefully planned and represent the best use of NHS resources.

What happens if the drug has not been approved by NICE?

If a drug is waiting for consideration by NICE or the drug has already been considered and turned down, it means that the hospital will not have received approval from the PCTs to start using the drug. In the case of new developments, the hospital cannot offer a treatment to one or two people unless we are able to offer it to all others who might need it. However, just one of a number of new treatments which might benefit some patients in one year would mean be an extra cost of one or more million pounds.

You may consider the following options:

1. The drug may be available to some patients who take part in a clinical research trial. Your consultant will be able to tell you if there are any trials of new treatments that would be suitable for your type of cancer.

2. You may wish to make an application to your local Primary Care Trust (PCT), to ask them to consider approving the treatment in your case.

If you wish to do this, your consultant will ask you to sign a standard application letter to send to the PCT. This will also give permission for your consultant to send information about you to the PCT in support of your application and confirm that the decision to provide the treatment is one that he or she would recommend.

The hopsital will send this application letter and supporting information to the PCT. They will ask the PCT to let you know when the application has been received, when the application will be considered and the PCT’s decision when it is made.

3. If the PCT does not approve your application, then you are still entitled to pay for the drug treatment yourself if you have the personal funds to do so. This is called ‘co-payment’ or ‘top-up funding’.

Under this option, whilst you must make a commitment to pay for the drug (which may include extra costs to prepare and deliver this), all other aspects of your care will be as an NHS patient. Your consultant can explain about this option and arrange for you to receive more detailed information about the costs of your treatment for you to consider.

4. Patients who have opted for private healthcare may be able to receive drugs that are unavailable on the NHS. If you consider this option, then all your healthcare must be as a private patient for the duration of the treatment.

We realise how stressful and difficult this situation must be for patients and families. It is important to remember that there is no guarantee that a drug will be of benefit to all of the patients who might be eligible to receive it. In many cases there remain other standard treatments that can be given.

This information has been reproduced with permission from The Christie.

The Christie Patient Information Service March 2009
Review March 2012

This page was last modified on 25th November 2011 at 02:27

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