Thursday, 4 September 2008

Postcode lottery fight for cancer sufferer

By Emily-Ann Elliott

A cancer sufferer has launched a legal battle against a postcode lottery that threatens to shorten his life.

Colin Ross, 55, believes he would be given a life-prolonging drug if he lived just 12 miles from his home.

A barrister for Mr Ross told a judge it was an "end of road" legal challenge that could mean death in the next couple of months if he fails or his life being extended by up to three years if he wins.

Mr Ross was diagnosed with multiple myeloma, a cancer of the blood cells, in May 2004.

He has been told by doctors that unless he is given Revlimid he will not survive beyond the autumn.

It would cost £5,000 per course of Revlimid and his medical team have requested funding for an initial three to four courses.

But in March West Sussex Primary Care Trust refused to fund the drug, even though leading cancer specialist Professor Karol Sikora has said he is “eminently suitable” for treatment.

Richard Clayton QC, representing Mr Ross, told Judge Simon Grenfell at London's High Court, the trust’s decision was “irrational” and it had erred in its estimate of the cost effectiveness of Revlimid.

He said: “This application for this drug is the end of the road for him.

“Either he gets the drug and is able to have life-prolonging treatment, or he doesn’t and treatment ceases, with inevitable consequences.”

He told the court that in a recent survey, 60% of the applications made for exceptional funding with the drug in England and Scotland had succeeded but the trust did not consider Mr Ross’ case was exceptional.

He said the case raised the “random and disquieting” problem of treatment depending on a patient’s postcode.

Arriving at court Mr Ross, from Horsham, described how he had become the victim of an “East-West” divide a postcode lottery between East Sussex and West Sussex.

He said he had spoken to another cancer patient at the Royal Marsden Hospital in London four weeks ago.

He said: “We got chatting and the subject of Revlimid came up.

“She told me she had applied for the same drug earlier this year and had been put on it.

“I live in West Sussex, and she lives 12 miles down the road in East Sussex.

“She was astonished when I told her I had been refused. How can it be that, in such a little distance, one can have it and one cannot?

“It should not be like that. It is not right that I should have to go to these lengths to get such an important, life-extending drug.”

Mr Ross was accompanied to court by his long-term companion Wendy Forbes-Newbegin, 52.

She said: “The mental anguish he has been going through is nothing short of appalling.

“The stress of his illness is bad enough, but to have to fight for this treatment has just been disgusting.

“I have been suffering from breast cancer, and he was supposed to be looking after me.”

Mr Ross, who has two children and four grandchildren, said: “If I don’t win and I get no further treatment I won’t be here for Christmas, it is as simple as that.”

He acknowledged that Revlimid is not a cheap drug.

But he expressed his frustration that “the Royal Marsden are sitting there with the drug in their fridges”.

Mr Ross has so far had six complete courses of chemotherapy and also received stem cell treatment at the Royal Marsden.

He responded well to the two other drugs currently being prescribed on the NHS for myeloma patients, Thalidomide and Velcade, but was forced to stop taking them because of painful side effects.

However, while Revlimid is readily available to patients across Europe and in the US, it has not yet been granted approval by the National Institute for Health and Clinical Excellence (Nice) and so is currently only being provided by some Primary Care Trusts (PCTs) on the NHS in exceptional circumstances.

Mr Clayton accused the trust of misunderstanding the evidence of the survival benefits of Revlimid.

He said the trust had failed to take into account “the slim but important chance” that the drug could prolong Mr Ross's life by more than a few months and it had made a fundamental error “when balancing clinical efficacy and cost”.

Martin Forde QC, appearing for the trust, said its officials had “every sympathy” for Mr Ross’s predicament.

The trust had, to some extent, been roundly criticised over its decision that it would not be cost-effective to fund Mr Ross’s treatment.

But it was having to make “agonising decisions” and considered some 600 similar cases every year.

It was doing its level best to use limited NHS funds “in the most efficient manner to benefit the largest number of patients”.

In Mr Ross’s case, the trust did not accept that it had adopted an irrational funding policy - “nor do we accept the policy was implemented in the course of this agonising decision in a perverse or irrational manner”.

The hearing continues on Monday.

The judge indicated that he hopes to give his ruling by the middle of next week.

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