A cancer diagnosis is one of those moments in life when everything changes in an instant. Your whole world collapses around you. You are no longer the master of your own destiny. Instead your future rests in the hands of a bunch of medical experts, armed with an array of treatments designed to kill your cancer without killing too much of you at the same time.
If you are unlucky enough to be in this situation you would, of course, hope that the NHS has the very best available medicines at its disposal. But sadly this not the case - half of new cancer medicines are now too pricey for routine use by the NHS and doctors often have to treat patients with older, less effective ones instead that offer reduced life expectancy.
This shocking revelation comes from an analysis of the affordability of new cancer drugs over the last 15 years, based on appraisals by NICE, the organisation that decides whether or not a new drug is cost-effective for the NHS. The analysis shows that over the last 5 years, 49% of new cancer treatments were considered by NICE to be too expensive for routine use by the NHS, given their expected benefits for patients. This rejection rate has risen three-fold since 2001-2005, when only 15% of new cancer treatments were considered too expensive for the NHS.
Meanwhile, over this same period drug company profits have soared. In 2015, the top seven cancer drugs firms, which control 70% of worldwide sales, made an eye-watering average profit margin of 20.5%.
Drug companies often try to defend high prices by saying that new drugs are expensive to develop, but R&D costs are being recouped many times over and profit margins are higher than any other industry, so the companies are simply taking advantage of a lack of competition and regulation to hold patients to ransom.
Most of us love the NHS and trust it to give us the best possible treatment when we fall ill, but the shocking lack of access to the latest cancer treatments seriously undermines this trust.
It will be seen by many as yet another failure of the Government to protect the quality of NHS services in favour of mega-rich corporations, who are milking sick and dying patients for every penny they can get.
WHAT ARE THE OPTIONS?
So, what happens when a new drug is too expensive for the NHS?
At present the Government either pays the high price demanded by the drug companies, or it refuses to pay, leaving patients to be treated with older, less effective medicines that offer reduced life-expectancy. This isn't just a tragedy for cancer patients, who are being condemned to an early death, but also a kick in the teeth for the public who have generously raised money to help pay for the discovery and development of these new drugs.
Some groups have called for NHS price caps to be raised but there are concerns that this will simply fuel further price escalation. The original Cancer Drugs Fund did just that - the fund provided extra money so that the NHS could pay higher prices for cancer drugs than drugs for other diseases, thereby giving cancer patients access to many drugs that NICE had rejected as too expensive. However, five years after its inception, the fund ran out of money, drug prices were still rising, many drugs had to be withdrawn and the Government had failed to deliver on its promise to introduce value-based pricing as a longer-term solution.
It is very clear that we won't solve the problem of high cancer drug prices by just giving drug companies more money whenever they ask for it - that will only encourage them to raise prices even further in the long run.
So, what is the solution?
Long-term we need to completely overhaul the system for funding the development of new drugs, but in the short-term the Government should stand up to the drug companies and take back control of the situation.
If an unreasonably high price is preventing the NHS from treating patients with the best available drug, the Government doesn't have to let patients die - it has the legal powers to obtain drugs from a more affordable source.
Under the Patents Act 1977, the Government can effectively override the drug company's patent by invoking "Crown Use" provisions, which allow the Government to make use of patents without the authorisation of the patent-holder. It can then permit copies of the drug to be manufactured or imported into the UK by alternative suppliers, allowing it to negotiate access to the drug at a more affordable price.
Some people argue that this will discourage drug companies from making future investments in new drugs but the idea that drug companies will down tools and stop producing new drugs is frankly laughable and there is no empirical evidence to support this - it would be like going on hunger strike; new drugs are the food supply that keeps drug companies alive. And if, in the unlikely event, that did happen, it would in any case be far cheaper to carry out R&D for new drugs in the public sector.
So, the only question is whether our Government is more interested in protecting the lives of ordinary people or protecting the profits of drug company shareholders.
If, like me, you are unhappy that the Government is turning a blind eye to the commercial exploitation of cancer, please join over 4000 people who have signed the Dying for a Cure campaign's online petition to Stop Profiteering from Cancer.