The Sunday Post (Dundee)

Cash concerns over end-of-life medicine

- By Andrew Picken apicken@sundaypost.com

HEALTH chiefs have raised concerns about the amount of money being spent on medicines to help dying patients.

A fund that pays for new drugs for those with rare conditions or approachin­g the end of their life was doubled to £80 million last year.

The decision was taken amid reports seriously- ill Scots were being denied treatments available to people south of the Border.

But now a string of cashstrapp­ed NHS boards have questioned the affordabil­ity of handing expensive treatments to patients at death’s door.

In its submission to a Holyrood review of the “new medicines fund”, NHS Borders said targeting resources at drugs which t r e at ra r e conditions was fair.

But it added that it seemed “hard to justify” for end-of-life treatments.

It went on: “Why should treatment at this stage of life be prioritise­d above other life stages and why should different cost effectiven­ess thresholds apply?”

More than 1,000 people have received new treatments as a re s u l t of the new medicines fund – including many in the final stages of their lives.

It typically costs between £15 and £25,000 to treat dying patients even though the drugs they are given often only prolong their lives by a matter of weeks.

NHS Borders argued that there is limited evidence to show these t re a t m e n t s improve quality of life for those who are terminally ill.

It also raised concerns that patients at other stages in their treatment were being denied drugs “of proven effectiven­ess” because health chiefs had diverted so much money to those approachin­g the end of their life.

Similar concerns were raised by officials at NHS Greater Glasgow and Clyde ( NHS GG&C) and NHS Lothian.

In its submission, NHS GG& C sa i d : “In a fin i t e healthcare budget, decisions that i n c re a s e access to medicines with more marginal benefits impacts on ability to deliver other healthcare services.” Meanwhile, NHS Lothian stated: “The public should be aware that NHS resources are finite, and it will be impossible to fund all new medicines and treatments without considerin­g the impact on other patients.”

Britain’s use of effective new medicines for conditions such as cancer is just a tenth of other European countries.

But in 2014, the Scottish Medicines Consortium, which dictates what drugs should be used by the NHS, was given more flexibilit­y in evaluating medicines for end- of- life patients and those with rare conditions.

In January Health Secretary Shona Robison, left, announced an independen­t review of the way drugs are assessed for use on the NHS.

At the time she said: “Access to new medicines for rare or end- of- life conditions is an extremely complex issue.

“Wi t h new t re a t m e n t s coming to market all the time, it is important to take stock of the p ro g re s s to dat e to continuall­y assure ourselves that our systems for assessing and accessing new drugs are keeping pace and meeting the expectatio­ns of patients.”

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