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Paying for better health: Should patients be able to pay for expensive cancer drugs?

In the last month there have been a number of cases of patients with terminal cancer appealing for access to novel drugs that are not currently funded under the NHS. In Scotland yesterday a man with terminal bowel cancer succeeded in his battle to get NHS funding for a new and expensive drug cetuximab. This follows the recent publicity over two patients with breast cancer who have been fighting to be allowed to pay privately for another new drug bevacizumab.

These drugs are genetically engineered antibodies developed by a US biotech company to target growth factors commonly found in tumour cells. The drugs have been shown to improve survival of patients with some cancers, but evidence is lacking in other types of cancer.

This sort of dilemma is not unique to the UK. There is similar debate about access to bevacizumab in Canada and Australia. Some of the debate is about the science, and whether or not the drugs have been conclusively proven to be of benefit. However there are also ethical questions about the rationing of expensive treatments in public health care systems. It is generally accepted that there are finite resources available for healthcare, and that not all treatments can be afforded. But if public funding isn’t available for health treatment should patients be able to pay privately to access them?

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Our Obligations to the Poor

The relationship between the rich and the poor countries of the world has been questioned in a number of ways today. Oxfam have released a report, Investing for Life, which suggests that pharmaceutical companies are missing an important opportunity by not focussing their attention on the large health problems of the poorest countries. At the same time, in the US, apparently significant developments have been made in the production of drought–resistant crops and, in the UK, the government’s chief scientific adviser will call for a rethink on GM crops.

These two issues pull in interestingly different ways. In the first case, the challenging question is how best to balance the value of a market-based research industry with the need to provide assistance to the poorest countries. In the second, the challenge is the price we are prepared to pay for our worries about genetically modified crops. In both cases our obligations to the poor sheds important light on the values of our society.

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Good drug, bad drug?

News The Lancet has published two articles on the efficacy and safety of the anti-obesity drug Acomplia.  This has been widely reported in the news as showing that patients using the drug have well over double the risk of depression and anxiety.  This comes on top of US studies linking Acomplia to suicidal thoughts. Commentary… Read More »Good drug, bad drug?

Home medical diagnosis

The earlier we can diagnose serious illnesses, the more we can do to cure them. Many advances have been made in diagnosis over the last century, but a serious bottleneck has remained. The patients need to come to a medical practitioner in order to be diagnosed and this means that they need to wait for… Read More »Home medical diagnosis

Fat Taxes and the Nanny State

Two reports published today make recommendations about the way in which obesity should be treated in the UK. These two reports, Public Health: Ethical Issues produced by the Nuffield Council on Bioethics and British Fertility Society’s guidelines on the effect of obesity on female reproductive health both contain important analysis of the role of the… Read More »Fat Taxes and the Nanny State