title: Access to expensive drugs in the NHS: myths and realities for cancer patients.
abstract: METHODS
  Patient support organisation (Myeloma UK) and Hospital Myeloma Clinic.
  
  
  METHODS
  Case review of two patients, one whose treatment is funded by a private insurance company in the UK, and the other who is funded by the National Health Service (NHS) and questionnaire survey of 51 haematologists from Myeloma UK database.
  
  
  RESULTS
  The treatment options available for private patients with myeloma in the UK are broader and more in line with national and international practice than are options available to UK NHS patients. 22/41 (54%) of respondents had received refusals to fund bortezomib by NHS funding agencies; all the rejections had been from Primary Care Trusts in England, which are governed by guidance issued from a different regulator than the other UK countries and subject to divergent local funding arrangements; 19/46 (41%) felt that it was currently (May 2007) more difficult to obtain funding approval for one treatment, bortezomib, than in September 2006, when it received a negative recommendation from the National Institute for health and Clinical Excellence and 15/17 doctors who prescribe on the NHS and privately felt it was easier to obtain bortezomib for a private patient than an NHS patient in the UK.
  
  
  CONCLUSIONS
  The current funding arrangements for new drugs to treat myeloma in the UK are inequitable and do not lend themselves to achieve the best possible outcome for patients.
authors.affiliation: Department of Haematology, Royal Free Hospital and Royal Free and University College London School of Medicine, London, UK. atul.mehta@royalfree.nhs.uk
authors.forename: A B
authors.initials: AB
authors.lastname: Mehta
authors.forename: E
authors.initials: E
authors.lastname: Low
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics; D017149:Private Sector; D013222:State Medicine / Q000191:economics*; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents