FROM LONDON DAILY TELEGRAPH...Kidney patients denied 'too expensive' life-extending drugs
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From: sheder1 on 7 Aug 2008 09:51 Kidney patients denied 'too expensive' life-extending drugs Cancer patients are to be denied drugs which could keep them alive after the NHS rationing watchdog ruled that they are too expensive. By Kate Devlin. Medical Correspondent Last Updated: 10:50AM BST 07 Aug 2008 Comments 26 | Comment on this article James Whale, the broadcaster who was diagnosed with kidney cancer in 2000 James Whale, the broadcaster who was diagnosed with kidney cancer in 2000, has urged Nice to think again Photo: ROGER TAYLOR Patient groups said the decision, announced today by the National Institute for Health and Clinical Excellence (Nice), would condemn many sufferers of kidney cancer to an "early death". The four prohibited medicines include Sutent, which can prolong life in kidney cancer patients by up to two years. The draft guidance also rejects Avastin, Nexavar and Torisel. Nice said the drugs were too expensive, at about £24,000 a year per patient, for the benefits they offered and would mean the health service was less able to afford more cost-effective drugs for other illnesses. However, the decision reignites the debate around how the NHS prioritises which drugs are approved for use. It comes just a week after Andrew Dillon, the chief executive of Nice, said smokers and the obese should not be denied NHS medication because of their lifestyle. Following Nice's latest decision, one surgeon said there would be no point in accepting kidney cancer patients if he was not able to prescribe Sutent because so few respond to other treatments. Prof John Wagstaff, from the South West Wales Cancer Institute, in Swansea, said: "The possibility that we clinicians may be prevented from offering Sutent to our patients is an outrage. "This decision will mean that the UK will have the poorest survival figures [for the cancer] in Europe." Prof Peter Littlejohns, Nice's clinical and public health director, said: "Although these treatments are clinically effective, regrettably the cost to the NHS is such that they are not a cost-effective use of NHS resources." He added that the organisation had to make some of the "hardest" decisions in public life. Around 7,000 patients are diagnosed with kidney cancer in Britain every year. The disease progresses to the advanced stage in around 1,700 cases annually. Approximately 3,600 patients in Britain would be eligible for Sutent, which acts against the growth of advanced kidney cancer and is available more widely in France and Germany. Campaigners said patients would be left with just one other option, Interferon, but many sufferers do not respond to the drug. Otherwise they would have to pay for the drugs privately. Nice previously faced controversy over its advice that Herceptin, the breast cancer drug, could only be used for advanced cases. Following a sustained campaign and legal battles the drug was allowed for early stages of the disease. In May, the Court of Appeal ruled that Nice had been procedurally unfair in refusing to give anti-dementia medicines such as Aricept, costing about £2.50 a day, to thousands of Alzheimer's patients. They have so far been denied the medicines, and are awaiting Nice's economic reasoning. James Whale, the broadcaster who was diagnosed with kidney cancer in 2000, said Sutent had given many families "hope for the future" and urged Nice to think again. He said: "If final guidance remains as it currently stands it will certainly mean an early death sentence for many." Some local health care trusts have been offering the drug to small numbers of patients. William James Lloyd, 62, was given Sutent after being diagnosed with cancer three years ago, and says it allowed him to see the birth of his two youngest grandchildren. The retired headmaster from Llanddewi Brefi in Ceredigion, west Wales, said: "This drug has let me live to see things I could not have seen otherwise." Nice does not intend to offer a final decision until January. Patients already on the medication should continue to receive the drugs until they and their doctor think it is appropriate to stop treatment, according to the guidance. Pat Hanlon, from Kidney Cancer UK, said that the decision would have a "devastating impact on patients"
From: Old Bill on 7 Aug 2008 14:56 "sheder1" <turtletrot1(a)bellsouth.net> wrote in message news:beb31471-53f6-45c3-8773-fec3eae57d11(a)59g2000hsb.googlegroups.com... Kidney patients denied 'too expensive' life-extending drugs Cancer patients are to be denied drugs which could keep them alive after the NHS rationing watchdog ruled that they are too expensive. By Kate Devlin. Medical Correspondent Last Updated: 10:50AM BST 07 Aug 2008 Patient groups said the decision, announced today by the National Institute for Health and Clinical Excellence (Nice), would condemn many sufferers of kidney cancer to an "early death". The four prohibited medicines include Sutent, which can prolong life in kidney cancer patients by up to two years. The draft guidance also rejects Avastin, Nexavar and Torisel. Nice said the drugs were too expensive, at about �24,000 a year per patient, for the benefits they offered and would mean the health service was less able to afford more cost-effective drugs for other illnesses. However, the decision reignites the debate around how the NHS prioritises which drugs are approved for use. Following Nice's latest decision, one surgeon said there would be no point in accepting kidney cancer patients if he was not able to prescribe Sutent because so few respond to other treatments. Prof John Wagstaff, from the South West Wales Cancer Institute, in Swansea, said: "The possibility that we clinicians may be prevented from offering Sutent to our patients is an outrage. "This decision will mean that the UK will have the poorest survival figures [for the cancer] in Europe." Prof Peter Littlejohns, Nice's clinical and public health director, said: "Although these treatments are clinically effective, regrettably the cost to the NHS is such that they are not a cost-effective use of NHS resources." He added that the organisation had to make some of the "hardest" decisions in public life. Around 7,000 patients are diagnosed with kidney cancer in Britain every year. The disease progresses to the advanced stage in around 1,700 cases annually. Approximately 3,600 patients in Britain would be eligible for Sutent, which acts against the growth of advanced kidney cancer and is available more widely in France and Germany. Campaigners said patients would be left with just one other option, Interferon, but many sufferers do not respond to the drug. Otherwise they would have to pay for the drugs privately. Nice previously faced controversy over its advice that Herceptin, the breast cancer drug, could only be used for advanced cases. Following a sustained campaign and legal battles the drug was allowed for early stages of the disease. Pat Hanlon, from Kidney Cancer UK, said that the decision would have a "devastating impact on patients" According to the Western Mail,Cardiff, it is Prof.John Wagstaff who says "there would be no point in accepting kidney cancer patients if he was not able to prescribe Sutent because so few respond to other treatments" not "one surgeon" as stated in the Telegraph. this is what the Western Mail says: 'Prof John Wagstaff from the South Wales Cancer Institute said there was "no Point" in him (sic) now acccepting referrals for people with advanced kidney cancer as about 75% of them "Do not gain any real benefit" from interferon.'. He also says: 'The possibility that we clinicians may be prevented from offering Sutent to our patients is an outrage ... ...'. Prof Wagstaff is talking about turning patients away when 25% of them will benefit from the current treatment which he has to offer. Thus he condemns one third of them to premature death. So where does the 'outrage' lie? Old Bill
From: Old Bill on 7 Aug 2008 15:06 "Old Bill" <matbeta(a)yahoo.com> wrote in message news:g7fgit$gnl$1(a)news.datemas.de... | | "sheder1" <turtletrot1(a)bellsouth.net> wrote in message | news:beb31471-53f6-45c3-8773-fec3eae57d11(a)59g2000hsb.googlegroups.com... | | Thus he condemns one third of them to premature death. | | So where does the 'outrage' lie? | | Old Bill | | Sorry,should have been one quarter not one third. Old Bill
From: J on 8 Aug 2008 07:05 Old Bill wrote: > "sheder1" <turtletrot1(a)bellsouth.net> wrote in message > news:beb31471-53f6-45c3-8773-fec3eae57d11(a)59g2000hsb.googlegroups.com... > > Kidney patients denied 'too expensive' life-extending drugs > Cancer patients are to be denied drugs which could keep them alive > after the NHS rationing watchdog ruled that they are too expensive. > > By Kate Devlin. Medical Correspondent > Last Updated: 10:50AM BST 07 Aug 2008 > > Patient groups said the decision, announced today by the National > Institute for Health and Clinical Excellence (Nice), would condemn > many sufferers of kidney cancer to an "early death". > > The four prohibited medicines include Sutent, which can prolong life > in kidney cancer patients by up to two years. The draft guidance also > rejects Avastin, Nexavar and Torisel. http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Genitourinary/Kidney/Management/default.htm # Chemotherapy, such as vinblastine or other chemotherapy agents, is not recommended. # Interferon-alpha has proven superiority over medroxyprogesterone acetate within a randomized trial in patients with metastatic RCC. Interferon-alpha provides response rates of 6-15% resulting in a modest survival benefit of 3-4 months. Single patients with long term survival have been reported. Only good prognosis patients appear to benefit, so generally, only highly selected RCC patients with good prognosis features should be considered for interferon. This includes patients with clear cell histology, good performance status, a progression-free interval following initial diagnosis of more than 1 year and preferably lung metastases as the sole metastatic site. # Other cytokines such as interleukin or cytokine combinations such as interferon plus interleukin have not shown significant benefit in randomized trials or have not been validated compared to best supportive care in randomized trials. # Patients that have had nephrectomy with a good disease-free interval and are found to have asymptomatic recurrence.(e.g. small lung metastases) may also be observed without treatment. Such a period of observation can be very prolonged in selected patients. This allows a better knowledge of the tempo of the disease and is associated with a better quality-of-life than any of the systemic treatments. This appears to be a safe alternative to immediately starting treatment as long as patients remain under close observation. Treatment should be initiated upon progression. http://www.manchestereveningnews.co.uk/news/s/1060820_jean_loses_sutent_battle Last summer broadcaster Tony Wilson, who later died of a heart attack, had to rely on showbiz friends to pay for the drug because health bosses wouldn't approve the treatment. Salford Primary Care Trust said that a small number of studies on the effectiveness of Sutent, indicate that for the majority of patients - around 60 per cent - the drug had no effect in delaying the progression of cancer. In 40 per cent of sample studies, there was an indication that the progression of the disease was delayed typically, for eight months. The Trust says that while Sutent is an advance in the treatment of Mrs Murphy's type of cancer, it does not provide a cure to what is inevitably, a terminal condition. It says the Trust is investing new money into cancer services for Salford people, including �1.5 million for services at Christie, �700,000 at local hospitals and �430,000 on breast cancer screening. By funding Sutent treatment, it says the Trust would have make choices about which other services not to fund. <http://uk.reuters.com/article/healthNewsMolt/idUKN1226236020080213. > Pfizer's Sutent causes heart failure in some: study Wed Feb 13, 2008 2:00 WASHINGTON (Reuters) - Fifteen percent of patients who took Sutent, a pill used to treat kidney and stomach cancers, developed heart failure, U.S. researchers reported on Wednesday. The study, presented at a meeting of cancer specialists, confirmed other studies that suggest the drug causes the risky but reversible side-effect. "Cardiac adverse effects need to be carefully examined in future trials of sunitinib to determine the factors that place patients at risk for this complication. That information will allow us to administer this medication more safely to patients for whom the benefits of treatment clearly outweigh the risks." While heart failure is serious, it can be treated with a variety of drugs. When caused by drugs, stopping the medication usually clears up the problem. Her team studied 48 patients with kidney cancer or gastrointestinal stromal tumor (GIST) who got Sutent. Seven of them, or 15 percent, experienced heart failure, a chronic condition in which the heart loses its ability to pump blood properly, she told the American Society of Clinical Oncology meeting. Sutent works by starving tumors -- it stops them from growing blood vessels to feed themselves. It is being widely tested for the treatment of several other cancers. In December, researchers reported in the medical journal Lancet that half of 75 patients with GIST who took the drug in a clinical trial developed high blood pressure, 8 percent developed heart failure, and two had heart attacks.
From: J on 8 Aug 2008 07:16
J, no> wrote: > Old Bill wrote: > Apology to Bill. I (apparently)picked the wrong post to reply to (and snipped the rest) . J |