Girl loses legal fight over drug on NHS

A GIRL at risk of brain damage as a result of a rare condition has lost a High Court bid for a drug to be made available on the NHS.

Cait Cotter, 11, from Chelmsford, Essex, suffers from the inherited condition PKU, which inhibits the body’s ability to metabolise protein and could lead to “profound and irreversible brain damage”, unless she adheres to a strict diet.

The girl, who is treated by a consultant at Great Ormond Street Hospital, in London, successfully underwent a trial of the drug Kuvan, which allows her to increase her food intake and reduces her risk of brain damage.

However, she has not been able to continue with the treatment because it is not made available by the NHS.

Through her mother, Natasha Cotter, she challenged the decision of the National Institute for Health and Care Excellence (Nice) – the body that recommends which treatments should be provided by the NHS – to assess the drug on its standard basis, rather than using a more specialised process.

Her lawyers argued at a hearing in January that Nice’s decision to appraise Kuvan through its standard technology assessment (which has an upper cost-effectiveness limit of £30,000), rather than its highly specialised technology process, (with an upper limit of £100,000), was unlawful.

But in a ruling yesterday, Mr Justice Cavanagh dismissed her case, saying Nice was entitled to reach its decision in the way that it did and it was “not irrational”. The judge said: “It is Nice’s responsibility to decide which drugs to recommend for use in NHS England, against the background of a finite budget.

“In exercising that responsibility, Nice must have regard to the broad balance between the benefits and costs of the provision of health services in England, and must exercise its functions effectively, efficiently and economically.

“This means, unavoidably, that Nice must make difficult decisions which will disappoint people who have every good reason to hope that a drug or treatment will be recommended for use in the NHS in England,” the judge concluded.