Opinion

Rationing can happen here

Holly Pitt Young Contributor

It’s easy to get into a policy discussion about rationing late-stage cancer drugs without considering the practical effects rationing could have on cancer patients. But by reading the British press, you can get a sense of the pain, anguish, anxiety and helplessness patients under a government-run health care system feel when a life-extending drug is yanked from their hands.

In Great Britain, the government-run health service has decided to deny coverage of Avastin to bowel cancer patients, despite evidence that the drug extends life.  Unlike our own Food and Drug Administration, which is considering dropping coverage for the drug for breast cancer patients, the Brits are honest about their intentions and reasoning. Professor Mike Rawlins, the chairman the British National Institute for Health and Clinical Excellence (NICE) said: “The question is not whether care is rationed,” he insists, “but how.” He has pointed out that decisions about how to ration health care are going to get more acute in the next six years as three factors collide: Britain’s population increases by at least three million; the number of people over 74 rises by more than 20 percent; and spending on the NHS is reduced, in real terms, by £20 billion.

In August, The Guardian, a British newspaper, reported:

A teacher diagnosed with terminal bowel cancer today said she was extremely disappointed the health watchdog has turned down a “life-saving” drug for use on the NHS. Barbara Moss, 55, (below) said she was “living proof” that Avastin works.

In November 2006, she was given three months to live after doctors discovered the cancer had spread to her liver. After two treatments of Avastin, her grapefruit-sized tumor shrank to half its size and she could have surgery. She has been in remission for 18 months.

Mrs. Moss said the National Institute for Health and Clinical Excellence (Nice) had put a “value on life” after it said the price was too high for the extra benefit it gives patients.

Moss, from Worcester, said: “To say that I am disappointed is an understatement. I am still here — alive.

“I have seen people dying who were less ill than I was. They could have been alive if they had it.

“It seems immoral to me that, as a result of negative Nice decisions like this one, people’s choice of living or dying depends on whether they can afford a drug, because it isn’t available to them on the NHS.”

Moss had to pay £21,000 to be treated with Avastin. Her primary care trust has since refunded her the money. “I have now been in remission for 18 months and I feel absolutely fantastic. “Because I had the operation to remove it and because of the Avastin, I am alive today.”

Other patients have started petitions and Facebook pages to try to get the drug.

Proponents deny that rationing could ever happen here.  But it can and might soon if some in the FDA have their way.

Holly Pitt Young has over 15 years of experience working with organizations to develop successful government and public affairs strategies.