Capitalism is the cancer

Some doctors called it “an unethical political fix”. The Cancer Drugs Fund, was set up at the prime minister’s behest to bring last-chance drugs to dying patients, and it is expected to have its soaring costs severely cut by an NHS England review. Pharmaceutical companies have already expressed outrage because their drugs will no longer be bought through the fund and have warned that thousands of terminally ill cancer patients will lose crucial palliative care. New cancer drugs can add months to patients’ lives, but can cost £90,000 a course.

Many health experts say that the reining in of the fund – set up to promote expensive cancer medicines in priority to drugs for all other diseases – reveals its creation was merely a politically expedient move aimed at ending the embarrassment of tabloid tales about cancer patients being denied “life-saving” drugs. They want the CDF to be axed.

Professor Richard Sullivan, director of the Institute of Cancer Policy, London, explained: “You cannot give priority to cancer over all other serious illnesses, including coronary ailments and dementia. These types of patients are just as deserving of expensive medicines as are cancer patients.”

Health economist Professor Karl Claxton, of York University said, “Last year the Cancer Drugs Fund spent £280m on medicines. That money did some good but it would have done a lot more if it had been spent elsewhere in the National Health Service.” According to Claxton, 21,645 quality adjusted years of life – a measure of health improvement that is provided by a medicine – would have been added to patients’ lives if that £280m had been used by the NHS on all illnesses. By restricting this money to cancer fund patients, fewer than 5,600 quality adjusted years of life were added to lives. “Quite frankly, this has been an appalling, unfair use of NHS resources,” Claxton added.

Mangesh Thorat, a cancer surgeon at Queen Mary’s Hospital London pointed out, “It is very hard to tell a patient there is a drug that could add several months to their lives but that we cannot afford to give it to them. On the other hand, in saying that cancer cases deserve exemptions from cost controls – while other diseases are not permitted these exemptions – is basic discrimination. You are saying that one type of disease is more important than any other type. In fact, the problem of high-cost drugs is always going to be with us. The Cancer Drugs Fund is completely the wrong answer to the issue.”

The Cancer Drugs Fund was robustly defended by the lobby group which represents drug supply companies, the Association of the British Pharmaceutical Industry. National Institute for Health and Care Excellence (Nice) used to negotiate prices of new drugs with pharmaceutical firms and would eventually give approval after those companies agreed to lower their prices. The Cancer Drugs Fund allowed the companies to continue to demand top prices. As a result, its budget soared. “That’s why the fund is now trouble,” Sullivan added.

The pharmaceutical companies will insist that the gross inflation between cost and sale price is to cover the huge expenditure that goes into the complete lifecycle of creating the drug - discovery, research, testing and so on. What they aren't so quick to admit is that this includes their own advertising campaigns - which may run up to a third of the total cost. They advertise to increase their profits, not to research new treatments, yet we pay for their advertising budget under the guise of "total cost of development". CDF may indeed a waste of NHS cash. But this is minutiae to the larger problem. Pharmaceutical companies who think they're untouchable, mostly because governments like ours treat them as though they are. Pharmaceutical companies will charge what the market will bear, which is usually the maximum, when faced with cancer. How many times have we been told that a drug can't be supplied on the NHS because it's prohibitively expensive? Compare that to how many times we've been told that a drug can't be provided on the NHS because the manufacturer has imposed an unrealistic, unsustainable and exploitative price.

Incredibly, everything about capitalism is about competition – even life itself. It seems that the ruling class is not content with causing hostility between ordinary working people not receiving benefits and those who do, those in low paid jobs and those who are not in paid employment, those who are born in the UK and those who aren't and those in the public sector and those in the private sector. Now the ruling elite are causing hostility between those with one serious, life threatening illness and those with a different serious, life threatening illness.

We need to stop this pathetic in-fighting and target the root of the problem - capitalism