Blackadder’s Lair

The home of many a cunning plan

Cancer Patients Not Told of New Treatments

A cancer charity has today published research that shows doctors are keeping cancer patients in the dark about new treatments that could extend their lives.

Myeloma UK, which conducted the research, said a quarter of myeloma specialists questioned in a survey admitted hiding the facts about treatments that may be difficult to obtain on the NHS.

The main reason given was to avoid distressing or confusing patients.

Myeloma is a bone marrow cancer that affects around 3,800 people each year in the UK. Of these, 2,600 are likely to die from the disease.

More. Now I know what you’re thinking. They have universal health care in the UK, so how could it be that these treatments “may be difficult to obtain”?

In this case, the culprit seems to be the Orwellianly named N.I.C.E. (National Institution for health and Clinical Excellence):

Dr Atul Mehta, a haematologist consultant at the Royal Free Hospital, London, said: “These survey findings reveal the dismal state of UK cancer management. Despite significant advances in the treatment of myeloma, such as Revlimid, the majority of patients cannot get access to new life-extending drugs until they have been appraised and approved by Nice – a process that can take up to three years from when the drug is first licensed in the UK.

Since I’ve been accused in the past of focusing only on the problems with other countries health care systems, I’ll add that the U.S. system is hardly perfect in this regard. Under the FDA, new drugs are kept off the market, sometimes for years, out of safety concerns even though not having the drug can be the difference between life and death for many patients. In the words of one economist: “[T]he benefits of FDA regulation relative to that in foreign countries could reasonably be put at some 5,000 casualties [not lives] per decade or 10,000 per decade for worst-case scenarios. In comparison, it has been argued above that the cost of FDA delay can be estimated at anywhere from 21,000 to 120,000 lives per decade.” Whether adding our own Nice on top of the FDA and other existing regulations would improve matters is, of course, another question.

(HT: Coyote Blog)


September 9, 2008 - Posted by | Health Care


  1. One of the balances, which the FDA seems incapable of taking into account, is how bad is the effect of _not_ using a potentially risky medicine.

    As my father wryly asked a couple times when being warned about the dangers of certain cancer treatments: “What’s it going to do? Kill me?”

    If there’s a 1/10 chance of a drug used to treat non-fatal maladies of causing a fatal reaction, you would never use it. If there was a 1/10 chance of a drug for a form a cancer that would normally kill you within months causing nasty side effects, few people would balk at that.

    Comment by Darwin | September 10, 2008 | Reply

  2. The problem is that is someone dies from a drug approved by the FDA, they take the blame, but if someone dies because they couldn’t get a drug not approved by the FDA, people don’t even notice. Given those incentives, it’s unsurprising that the FDA tends to err in favor of keeping drugs off the market.

    Comment by blackadderiv | September 10, 2008 | Reply

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