Aims: This Handbook represents initial good practice guidance and resources to help PCTs to review current decision-making processes about the funding of medicines with co-operation from Provider Trusts and other stakeholders. Intended audience: Healthcare professionals. Publication history information: Published February 2009. Access: Available to the general public.
Thousands of patients are suing AstraZeneca in US courts, claiming the anti-psychotic drug Seroquel caused weight gain and diabetes. The patients allege Seroquel, its second biggest selling drug worth $4.5bn (£2.7bn) a year, was marketed without adequate warning about possible side effects such as massive weight gain and the development of diabetes. However, this is denied by the company.
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 DoH and NICE. 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.
Jackson provides a meticulously argued, extensively researched and utterly compelling critique of the current regulation of phar- maceuticals. Her account of a medicine’s journey through the regulatory system in the UK paints a frightening picture of the widespread, predatory activities of profit-seeking pharmaceutical companies and the systematic failure of law and regulation effectively to hold them to account. The UK, with its well developed and well financed pharmaceutical industry and equally well entrenched tradition of state-run health care, provides a particularly fine case study for the exploration of the tension between the ideals of medicine and the pursuit of profit and, as such, it is to be hoped that this book will gain a wide, international audience.