The cost and availability of cancer medicines is a topical issue here in Australia. Patients and patient advocacy groups such as the Cancer Drugs Alliance are lobbying for the creation of a Cancer Drug Fund to give patients access to the latest cancer medicines available. Submissions for a Senate Inquiry into the ‘Availability of new, innovative and specialist cancer drugs in Australia’ have been made and a report is expected shortly.
Much of the debate here focuses on whether or not to establish a Cancer Drug Fund like the UK’s £200 million ($AU 539 million) Cancer Drug Fund established in 2011. However the debate in the United Kingdom has moved on. After a significant budget blow out, with expenditure now estimated at £380 million ($AU 732 million), the UK is scaling back their cancer drug funding. By April, 25 treatments deemed to offer the least value to cancer patients will be delisted (have their funding withdrawn).
Some of the delisted treatments have only just been approved by the TGA in Australia.
This is an emotive debate made all the more difficult by the fact that there is no cure for cancer. Late stage cancer treatments can, at most, add months – albeit precious months – to a patient’s life. Few people would argue against patients getting timely access to beneficial treatments – but there is a cost.
Professor Peter Clarke, Chairman of the UK Fund said “We’ve been through a robust, evidence-based process to ensure the drugs available offer the best clinical benefit, getting the most for patients from every pound… These are difficult decisions, but if we don’t prioritise the drugs that offer the best value, many people could miss out on promising, more effective treatments that are in the pipeline.”
The Conversation (22 January 2015) reported that high-cost drugs in Australia account for 20% of the total budget, at a cost of $2 billion in 2013/2014. This proportion of high-cost drugs is likely to grow and with many new medicines being introduced to the market, often at a higher cost than older medicines, we need to work out how we’re going to fund medicines, particularly high-cost medicines, into the future.
In Australia, the cancer funding debate is mired in whether or not to establish a specialist fund. In the UK, the debate has moved on to look at how best to use finite resources to fund not only treatment of the sick but also to seek out better solutions for the future.
This is a complex and emotive issue to which there is no easy answer. However broadening the debate to more than just the establishment of a specialist fund would be a good start.
We need a societal debate that takes a long term view about how we’re prepared to fund medicines in Australia.