‘Breakthrough’ cancer treatment too pricey for NHS

A new drug seemed set to offer cancer patients a possible lifeline. Now the UK’s health service says it is not worth the cost – but can you really put a price on someone’s life?

When reports of a new drug called Zytiga emerged last year, it granted a new thread of hope to thousands of terminal cancer sufferers. Zytiga was developed to target a common and often incurable form of cancer, and in October its clinical effectiveness was finally proven.

But now, this new hope has been blasted for patients in the UK, where the drug was developed. Health authorities announced on Wednesday that Zytiga will not be purchased on behalf of the National Health Service (NHS), which means patients will not be able to get the treatment for free.

The treatment does what it is designed to do, and does it well. But Zytiga is not a cure: it can pause the spread of terminal prostate cancer for around four months – but beyond that it is powerless.

Four months of life is hardly a bad result. But at £3000 per month the drug is far from cheap. The medical agency which makes purchasing decisions, the National Institute for Clinical health and Excellence (NICE), with a budget to stick to, has decided that NHS money is better spent elsewhere.

Limited funds make these unpalatable judgements a fact of life for public health services: providing one treatment to prostate cancer patients might mean withholding a different treatment from people with other conditions – who might have even greater need.

Authorities like NICE exist in many countries to decide which drugs and equipment to buy. When scarce resources are allocated, those with a chance of recovery are often chosen over those fighting a desperate last stand against death.

But for sufferers, the decision to deny them a medicine that they need to go on living is, as one cancer charity put it, ‘a bitter blow’, not at all softened by the fact that it is logical.

Reason or feelings

Campaigners pressing for a reversal of the judgement see a cold, unfeeling hand at work.To skimp on a drug that might grant dying people a whole four months of life is indefensible: every moment of existence is precious beyond measure, they say. Health services should be willing to spend any amount of money to keep patients alive.

That, say many doctors, is a natural emotional response – but it is not the correct or rational one. We live in a world of limited resources. Given that fact, there will always be difficult choices to be made. All that people in a good society can do is ensure there is someone qualified to make them.

You Decide

  1. Would you choose to be treated even if the extra months of life you are given would be painful and tough?
  2. If a drug can keep someone alive does it matter how much it costs?

Activities

  1. Write a list of pros and cons to funding expensive cancer drugs like Zytiga. Which case do you think is stronger?
  2. What is cancer and how does it work? Create a simple graphic explaining the basics.

Some People Say...

“People who decide not to fund cancer drugs must be heartless.”

What do you think?

Q & A

How likely am I to be affected by prostate cancer?
If you are a man in the developed world, there is no other cancer you are more likely to suffer from. 13% of American males contract it in their lifetimes, while 37,000 cases are documented every year in the UK. But not all of them are terminal.
Was Zygita the only chance for those who were?
Well, there is still a chance that Zygita will be accepted in the second round of consultations. If not there may still be hope in another medication for late stage prostate cancer that is currently being reviewed in the USA. Even if these fall through, huge amounts of money are being poured into research aimed at finding a both treatment for prostate cancer, and a cure for cancer more generally. So there are reasons to be optimistic.

Word Watch

Zytiga
Also known as abiraterone, Zytiga has been hailed as one of the success stories in cancer research. The pill, which restricts hormone production, has taken decades to develop, and in the process shed light on how cancer works. However, it is expensive – and not a long-term cure.
Terminal
A terminal illness is one that is incurable. Usually it refers to one that will kill in a matter of months. Dealing with these illnesses is a whole branch of medicine, known as palliative care.
National Health Service
The NHS was founded in Britain in 1946 on the guiding principle that it should be ‘free at the point of need’ – in other words, paid for collectively by taxes and available to anybody who was ill, rich or poor. At the time when it was founded, this was a revolutionary idea.
Prostate cancer
The prostate is a gland in the male reproductive system that helps to produce semen. Prostate cancer is the most common form of male cancer in many countries, though its seriousness varies.

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