Increase cigarette tax by €5 to fund cancer treatments

AS MINISTER Paschal Donohoe puts the finishing touches to his Budget, he should think about three things that will inevitably happen in Ireland in 2019.

1) Approximately 200 million packets of cigarettes will be smoked.

2) Approximately 8,000 people will die from cancer, including 2,000 with lung cancer.

3) Many patients will be denied timely access to active anti-cancer drugs due to health service cost constraints.

Let’s look at the dramatic advances in lung cancer in recent years. New treatments have improved the outlook very substantially for both the common type of lung cancer which occurs in smokers and exsmokers, and the much less common variant typically seen in nonsmokers.

New immune system-based treatments have utterly revolutionised lung cancer treatment, especially for the types common in smokers.

Some patients with apparently hopelessly advanced cases are now achieving dramatic remissions. Some might even be completely cured.

Jim Allison and Tasuku Honjo shared the Nobel Prize last week for the discoveries which led to this treatment.

The drugs are expensive, and while access is improving here, we lag behind other peer nations. Access is better, for instance, in Greece.

And the companies bear a share of the blame due to over-pricing.

While there are many other competing demands on our health service money, there is no denying that in terms of new drugs, Ireland is now one of the ‘lower/slower’ access countries.

So, as new drugs emerge and are denied, we can either continue our endless national hand wringing, listening to the Government solemnly droning that it has to make ‘difficult decisions’ or we can try to do something about it.

Innovative solutions are clearly needed.

How about this one? A €5 tax on every pack of cigarettes and ringfence the money raised to deal with smoking-related diseases, including cancer. This would decrease smoking, raise €1billion for new treatments and ultimately reduce the smoking death rate.

Simple?

When I was in the Seanad I made a similar proposal. It was rebuffed by the Fine Gael/Labour Government because it was against government policy to do hypothecated (ringfenced or directed) taxes.

In other words, ‘we can’t do it because we don’t do it’.

Well what else will they do? They will probably deny the medicines.

The cancer good news stories are not all about drugs. A recent large study showed dramatic declines in lung cancer mortality for smokers and ex-smokers who underwent a routine lung screening scan every two years.

The improvement was particularly marked in women, who had a nearly two thirds reduction in their chance of dying.

This could save far more women’s lives than breast cancer screening with mammograms.

The revenue derived from my proposed smoking levy would easily pay for the lung cancer screening programme.

There is another reason to screen. With the rising cost of cancer drugs, it is highly likely screening will save money. Early stage cancers diagnosed at screening are far less likely to require the expensive new anti-cancer drugs. Stroke of a pen, Minister.

Voluntary disclosure: I have received support to attend medical conferences from Merck and BristolMyers who make lung cancer drugs.