LUNG cancer victims in England and Wales are to be denied a life-saving drug available on the National Health Service in Scotland — at least the eighth such decision in the past two years.

The National Institute for Health and Clinical Excellence (Nice) last week rejected Tarceva, which is used to treat lung cancer, on the grounds it is not an effective use of NHS resources.

The decision has led to complaints that Scots are getting preferential treatment — subsidised by taxpayers south of the border. Scotland receives extra funds under the Barnett formula and uses it to spend roughly 15% more per capita on health.

While Tarceva has been approved for use by the Scottish Medicines Consortium (SMC), it was rejected by Nice because it does not meet cost-benefit criteria. Cancer patients responded with anger to the decision, while Roche, the maker of the drug, said it would appeal.

Freda Matthews, 58, a retired teacher from Leicester, was diagnosed with nonsmall cell lung cancer in 2002. The illness accounts for about 80% of lung cancers and kills about 30,000 people a year.

Matthews had two rounds of chemotherapy before being prescribed Tarceva late last year. Now her access to the drug is in doubt. “Tarceva is keeping me alive, it is that simple,” she said. “I started Tarceva in December and when they did a scan six weeks later, the cancer had stopped growing.”

Tarceva costs about £1,700 a month and comes in tablet form, while rival drugs are administered intravenously. It is one of a new wave of cancer drugs that target specific cells. Matthews said the alternative was “horrific” chemotherapy.

“The only way you survive chemotherapy is by thinking that it will be worth it when you come out the other side. You don’t lose your hair with Tarceva.”

In Scotland, Dorothy Moffatt, 56, a senior administrative officer at St Andrews university, faces no threat to her supply of Tarceva, which she began in July last year.

“When the cancer came back the second time, I had spots on both my lungs and the chemotherapy didn’t work. Under the Scottish guidelines, I went on Tarceva,” she said. “I couldn’t believe that Nice had turned it down.”

Several other drugs have also been rejected by Nice, but are being used in Scotland, including the cancer drugs Velcade, Alimta and Gliadel.

Herceptin, a drug for breast cancer available in Scotland, was only released in England and Wales last August when Patricia Hewitt, the health secretary, overruled Nice. Last month, the SMC approved Exjade, which is used to treat genetic blood disorders such as thalassaemia, sickle cell and other rare anaemias. Alternative ways of controlling these disorders involve painful jabs that can last from eight to 12 hours, for five to seven nights a week.

There are no plans for Nice to assess Exjade, meaning the NHS will have no obligation to provide it.

Three drugs for Alzheimer’s disease — Aricept, Exelon and Reminyl — have been approved for Scotland but will be available on the NHS in England and Wales only to patients with more advanced symptoms.

Macular degeneration, which causes blindness, is halted by Macugen, a drug which has been approved for Scotland but has not been reviewed by Nice.

George King, who lives in Skelton, Teesside, was told he would be given Velcade, used to treat multiple myeloma, a form of cancer which kills 3,000 people a year, only after he threatened to move to Scotland to get the drug. It was approved by the SMC in 2004.

He said: “I still may have to go to Scotland. I’d have to rent a house, get on the electoral roll, register with a GP and then be referred to an oncologist.”

He has been discussing the possibility of renting a flat in Scotland with Jacky Pickles, a campaigner for the drug.

The equation used by Nice to decided whether to approve a drug incenses Nick Thatcher, an oncologist at the Christie hospital, Manchester. He believes that the calculation has been distorted since it was set up in 1999, decreasing the likelihood of the drug being approved.

“The methodology used in England and Wales is now completely out of step with mainland Europe and Scotland,” he said.

“The results of Tarceva are dramatic. Patients are alive rather than dead, which is about as dramatic as it gets.”

Bitter pills

“Wonder drugs” available in Scotland but not England and Wales:

- Tarceva, a lung cancer drug. Because it targets only specific cells, it does not have the damaging side effects of other forms off chemotherapy. It is administered by tablet.

- Velcade, a treatment for the aggressive bone marrow cancer multiple myeloma. The drug can extend life for up to seven years. Multiple myeloma kills 3,000 people a year.

- The Alzheimer’s drugs Aricept, Exelon, and Reminyl are available only to patients in England with advanced symptoms, not with the disease at its early stages as in Scotland. Doctors say the drugs significantly improve the quality of life of patients, but England’s drugs regulator argues they are not effective enough. Campaigners are trying to overturn the ruling in the High Court.

- Alimta, used for mesothelioma, which affects the lining of the lungs, and lung cancer, was approved in Scotland in August 2005. It costs about £8,000 to treat a patient. Supporters argue that the side effects of other drugs prolong stays in hospital.

- Gliadel, which extends the lives of patients with brain tumours, is implanted in patients at a cost of £5,000 a time. It was approved in Scotland in December 2005.

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