Expensive cancer drugs are only available to patients who "make the most noise" under a "patently unfair" system, a leading cancer doctor has warned.
By Kate Devlin, Medical Correspondent
Last Updated: 2:25PM BST 11 Sep 2008
Unless sufferers are allowed to buy the medication without losing the rest of their NHS care a "black market" in the drugs will open up, Professor Karol Sikora told Mike Richards, the Government's cancer Tsar, who is carrying out a review into controversial "top up" payments.
Support for top ups has been echoed by the King's Fund, the influential think tank, which said that the current system was "untenable".
The Government ordered Mr Richard's review following widespread outrage over cases of cancer sufferers who were charged as private patients after they bought potentially life extending drugs.
However, doctors have expressed concern that allowing "top ups" could lead to a two-tier NHS, where some patients get drugs which others cannot afford.
During a debate designed to inform Mr Richard's review, Prof Sikora, medical director of CancerPartnersUK, said that there was already an unfair system when it came to expensive cancer drugs: "If you look at the cases it seems that if you make a fuss you tend to get.
"If you don't make a fuss then you don't get.
"It is patently unfair that if you make a noise then you will get these drugs."
He went on: "If we leave the status quo, if we leave this typical British muddle, then an underground market (in these drugs) will develop."
He also called on the Government to "abolish" the Primary Care Trusts (PCTs) decision panels, which critics claim are leading to a "post code lottery" in cancer care.
NHS bosses can refuse to provide drugs if they have been rejected as too expensive by the Government's drugs watchdog, the National Institute for Health and Clinical Excellence (Nice).
If a drug has yet to be assessed by Nice then local PCTs can choose to give the drug in what it deems "exceptional" circumstances.
The call comes just 24 hours after a patient won access to a £4,000-a-course blood cancer drug after taking his local PCT to court.
Colin Ross, 55, was given just two months to live if he did not receive the drug, Revlimid.
The King's Fund, which hosted the debate, described the current system as "untenable" and said that under "certain circumstances" patients should be able to pay for their own drugs without losing the rest of their NHS care.
However, the Fund believes that those patients should also pay the extra costs associated with the drugs, such as the price of administering them, so that other NHS patients did not lose out.
Mr Richard's review is expected to report sometime in October.
Last month the Telegraph revealed that Nice was drawing up plans to provide patients with independent medical advice on drugs, including those which it had deemed too expensive, which could be offered to patients if a U-turn on top ups is announced.
The Conservatives have said that they are against introducing new charges into the NHS and have proposed a system where drug companies would be paid only if treatments work.
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