Cancer patient with months to live wins court order for last-chance drug on NHS
Colin Ross, 55, of Horsham, West Sussex, has multiple myeloma, a cancer of the blood cells, and was not expected to survive to see Christmas unless he was given a drug described as his “last chance”.
The High Court overruled the decision by West Sussex Primary Care Trust that treatment would not be cost-effective, and said that Mr Ross should receive Revlimid as an exceptional case.
Mr Ross had incurable cancer diagnosed in May 2004. In an interview with The Times last month he said that he was “sickened” that he was being denied the £30,000-a-year treatment even though the drug was available to patients living only a few miles away in East Sussex.
But despite the exhortations of doctors treating Mr Ross at the Royal Marsden Hospital, the specialist cancer hospital in London, the trust had, since March, repeatedly refused to fund the drug, raising the issue of a so-called postcode lottery for NHS treatments.
However, Judge Simon Grenfell, sitting in London, condemned the trust’s decision as “one which no reasonable authority could have made on the application before it”.
Revlimid is among the most expensive of new cancer treatments and is readily available to patients across Europe and in the United States and Scotland.
But it has not yet been granted approval by the National Institute for Curbing Expenditure (NICE) and, because of the cost, is likely to be rejected. It is provided by only some trusts in England and then only in exceptional circumstances.
The case is likely to encourage other cancer patients who may have been denied expensive drugs on the NHS, but experts emphasise that the case does not set a legal precedent and that decisions will be taken case by case in other areas.
The judge issued an emergency injunction to enable Mr Ross to begin treatment today, but the ruling was made on an interim basis pending a further appeal and not as the start of permanent treatment.
Mr Ross was too ill to attend court for the ruling but his long-term partner and carer, Wendy Forbes-Newbegin, 52, who has breast cancer, cried after the victory.
She said after the judgment that the family’s treatment by the NHS had been “appalling”.
“The mental anguish that we have been through has at times been unbearable, and wholly unacceptable in this day and age,” she said.
“Colin’s diagnosis and recent prognosis have been so awful in the first place, but to have to endure all the months of waiting for this life-prolonging treatment has been nothing short of shameful in the first degree.”
Mr Ross, who has two children and four grandchildren, told The Times that he feared that delays incurred by his appeals to the trust and ensuing legal action may have reduced the effectiveness of the treatment.
“Depending on what the judges say, I could start treatment with Revlimid, or the doctors will simply refer me to start receiving palliative care,” he said last month. “My bed in the hospice is already booked. I realise the drug is expensive for the NHS, but to think that I could have a few extra months or years to spend with my daughters and watch my grandchildren grow up – I’ve never wanted anything more.”
Before yesterday’s ruling he was taking a cocktail of painkillers and other drugs “just to keep my head above water”, and was advised that Revlimid was now the only option.
In March, Mr Ross’s clinicians asked West Sussex PCT to fund Revlimid for three to four courses at a cost of £5,000 a course and presented evidence to show that it could give Mr Ross up to three more years of life.
He had been unable to purchase the drugs privately, he said. “Even if I could, the law states that I would have to become a private patient and forfeit the rest of my NHS care.”
Richard Clayton, QC, acting for Mr Ross, told the court during a two-day hearing: “This application for this drug is the end of the road for him. Either he gets the drug and is able to have life-prolonging treatment, or he doesn’t and treatment ceases, with inevitable consequences.”
He added: “Were the claimant to live a mile and a half in either direction from where he does, he would have received the drug.”
West Sussex PCT said that it was considering whether to appeal.
Health Direct applauds the judiciary. Having had their power over life and death removed many years ago, it is heartening that they are taking the same power away from labour’s faceless health bureaucrats who are condemning thousands to premature deaths in the name of NHS cash shortages.