A strong vision for drugs access

As a cancer patient, being told the NHS doesn’t fund a drug which could give you priceless extra time with your family must feel heartbreaking and seem enormously unjust.

Every pound spent on a cancer medicine for one patient could always have helped another in a different way, and a fair health system is challenged to balance these spends on medicines against potential lives saved or improved if spent elsewhere.

Overall, the buck stops with the Scottish Medicines Consortium. It is here the tough decisions are taken that test the reality of limited NHS resources, not approving drugs because they are not proven clinically effective enough, are too expensive or both.

In this extremely emotive and challenging context, Dr Brian Montgomery has navigated to some brave and commendable recommendations for improving the current system.

Many of his recommendations are about the need for more and better data — vital to understanding the true impact of these drugs for patients and, crucially, minimising harms.

Also, the local decisions around individual funding requests for non-approved drugs can be confusing for patients and seem unfair, so recommendations that will help promote consistency between health boards must be supported.

We are entering a new era of “personalised medicines” — drugs that can be very effective in small numbers of patients, but often come with a hefty price tag. It’s positive that the report addresses the challenge of funding them. However, the high likelihood of a medium-term funding gap for cancer medicines — currently supported through a scheme with a precarious future — is an issue the Scottish government will need to see off soon.

Overall, Dr Montgomery can deservedly put his feet up for Christmas, knowing he has presented a strong vision of future access to drugs. The New Year resolution must be to quickly turn recommendations into reality for patients.