LONDON, Aug 15 (APM) - Thousands of National Health Service patients in the UK are missing out on access to innovative drugs which are available to patients living in some other countries of comparable wealth, research published on Monday from charities Breast Cancer Now and Prostate Cancer UK says.

According to theirreport, 'International Comparisons of Health Technology Assessment', a key reason for the UK's poor performance on access is the rigidity of the its appraisal systems, in that they lack the opportunity for negotiation on drug prices.

The report reviewed the drug systems and the availability of breast and prostate cancer treatments in England, Scotland and Wales compared to five similar countries: Germany, France, Australia, Canada and Sweden.

It shows for example that Roche's Kadcyla (trastuzumab-emtansine), which can offer women living with incurable secondary breast cancer an extra six months of life on average launched two and half years ago, is available in Germany, Canada and France, but can only be accessed by patients in England throughout the Cancer Drugs Fund (CDF) and not at all in Scotland and Wales, it said.

Looking at global health technology assessment bodies, the research also highlights that, in many cases, they play a key role in access but are only one part of a wider process, and notes the opportunity for assessment of peer systems to gauge whether any elements could be applied to improve access to cancer drugs for NHS patients.

The charities are now calling on the UK's Health Minister to review the current role of the National Institute for Health and Care Excellence (NICE), as well as work on renegotiating the current arrangements for the Pharmaceutical Pricing Regulation Scheme (PPRS) in time for 2018, "so that price negotiation can be brought into the system, enabling patients to access the best available treatments at prices that the NHS can afford".

"This report demonstrates the need for serious reform of the way our health system assesses, and determines the availability of, the cancer drugs that patients rely upon," said Baroness Delyth Morgan, chief executive at Breast Cancer Now.

"Pharmaceutical companies must indeed start offering more responsible prices. But until our health bodies are empowered to negotiate the price of cancer drugs, patients in the UK will continue to miss out on new treatments being offered elsewhere".

"Unfortunately the new CDF will not provide the change required to see the best new breast cancer drugs start gaining approval in England, and patients just cannot wait any longer. We desperately need the Secretary of State for Health to restructure the system to allow price negotiation and ensure that NHS cancer treatment does not fall any further behind the rest of the world."

Heather Blake, Director of Support and Influencing at Prostate Cancer UK, said: "Men cannot continue to spend years fighting for access to every new prostate cancer treatment. They need a more streamlined system for assessing and appraising cancer drugs which makes the right decisions first time around."

"Although last month's CDF reforms aim to address this issue, they place all the responsibility for patient access to new and innovative treatments on the pharmaceutical industry's willingness to lower its prices meaning that cancer patients once again have the potential to be left in limbo."

"Leaving patients with this uncertainty is unacceptable. And that's why action is needed to enable industry to negotiate new pricing models, and to give more weight to patient evidence so that the next generation of new cancer treatments reaches those in need," she added.

Dr Paul Catchpole, Director Value and Access at the Association of the British Pharmaceutical Industry (ABPI), said: "Patients in the UK face significant delays accessing medicines which are routinely available in other countries, both for cancer and other conditions."

"To suggest that the problem is just down to an inability to negotiate with pharmaceutical companies is too simplistic. Companies engage in pricing negotiations with the NHS but without doubt there is room for more creative approaches. This is despite the UK already having some of the lowest prices for medicines among similar economies and a deal which has seen companies pay back over 1.3billion pounds to the Government in the last 18 months to help keep NHS spending on medicines affordable," he added.

He said the concerns of the cancer charities - that some medicines will fail to get through the system - are real. The NICE evaluation programme has not kept pace with innovation and relies too much on a basic cost effectiveness threshold for assessing value for money and which remains unchanged in over 15 years.

"With cancer medicines now more effective than ever in extending life, we are seeing scenarios where some new medicines used in combination with established treatments would be rejected by NICE even if they were given away free due to the fact that patients are taking them for longer. The bottom line is that the system we have in the UK for assessing medicines needs to further evolve."

Catchpole added: "Only when we see a fundamental shift away from medicines being used as a cost containment exercise rather than part of a sustainable NHS will we begin to improve services for patients. If we want to improve survival rates for our patients we should be prepared to invest more, not less."

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