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Top‐up Payments for Expensive Cancer Drugs: Rationing, Fairness and the NHS
Author(s) -
Jackson Emily
Publication year - 2010
Publication title -
the modern law review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.37
H-Index - 22
eISSN - 1468-2230
pISSN - 0026-7961
DOI - 10.1111/j.1468-2230.2010.00801.x
Subject(s) - rationing , excellence , context (archaeology) , payment , health care , medicine , cancer drugs , health care rationing , access to medicines , business , public economics , economics , cancer , political science , nursing , economic growth , public health , finance , law , paleontology , biology
This article examines the implications for patient care, and for the future of rationing within the NHS, of the recent decision to permit NHS patients to supplement their care by paying for medicines — mainly expensive new cancer drugs — which are not available within the NHS. The starting point is the recommendations of the Richards' Report and their implementation through new guidance issued by the Department of Health and the National Institute for Health and Clinical Excellence. Practical challenges arise from the insistence upon the ‘separate’ delivery of self‐funded medicines, and more flexible cost‐effectiveness thresholds for end of life medicines may have repercussions for other patients. While undoubtedly part of the trend towards explicit rationing, top‐up fees might also represent a significant step towards regarding the NHS as a core, basic service. Finally, the issue of top‐up fees is located within the broader context of current cancer research priorities and persisting health inequalities.