This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.theguardian.com/theobserver/2016/nov/06/letters-nice-cancer-drugs-immunotherapy-approval-costs

The article has changed 4 times. There is an RSS feed of changes available.

Version 2 Version 3
Letters: Nice withholding approval of vital cancer drugs Letters: Nice withholding approval of vital cancer drugs Letters: Nice withholding approval of vital cancer drugs
(about 17 hours later)
Steve Hewlett’s comments about the refusal of the National Institute for Health and Care Excellence to approve an immunotherapy drug represents what I suspect is the tip of a very large iceberg of similar refusals in respect of immunotherapy drugs to treat various cancers. There is a lack of public awareness of this issue. Individual patients become aware of the drug that could help them. In my husband’s case, that is nivolumab, which Nice has to date not approved for the treatment of advanced lung cancer despite its use elsewhere, including Scotland.Steve Hewlett’s comments about the refusal of the National Institute for Health and Care Excellence to approve an immunotherapy drug represents what I suspect is the tip of a very large iceberg of similar refusals in respect of immunotherapy drugs to treat various cancers. There is a lack of public awareness of this issue. Individual patients become aware of the drug that could help them. In my husband’s case, that is nivolumab, which Nice has to date not approved for the treatment of advanced lung cancer despite its use elsewhere, including Scotland.
Oncologists know immunotherapy and gene therapy are the future for cancer treatment. However, it seems to be the case that Nice, without either public debate about or awareness of the issue, is denying access through the NHS to a whole range of new drugs on costs grounds. That means this country will fall even further behind the rest of the first world in cancer survival rates than it already is. It also means access to what science can now offer to cancer patients is effectively already rationed, as only those like Steve Hewlett and my husband who can (just about) pay for the drugs, or those with health insurance, are able to receive treatment.Oncologists know immunotherapy and gene therapy are the future for cancer treatment. However, it seems to be the case that Nice, without either public debate about or awareness of the issue, is denying access through the NHS to a whole range of new drugs on costs grounds. That means this country will fall even further behind the rest of the first world in cancer survival rates than it already is. It also means access to what science can now offer to cancer patients is effectively already rationed, as only those like Steve Hewlett and my husband who can (just about) pay for the drugs, or those with health insurance, are able to receive treatment.
There should be a full itemised statement from Nice of all such treatments that are not approved. I also believe that, in the face of the rapid advances in expensive treatments coupled with all the other pressures on the NHS, there needs to be a public debate on the question that politicians avoid: the need to look at alternative models of funding the NHS. Otherwise, we will end up with the current model offering increasingly developing world treatment to the majority, with only those who can afford them having access to modern effective drugs.Anne BraithwaiteLeedsThere should be a full itemised statement from Nice of all such treatments that are not approved. I also believe that, in the face of the rapid advances in expensive treatments coupled with all the other pressures on the NHS, there needs to be a public debate on the question that politicians avoid: the need to look at alternative models of funding the NHS. Otherwise, we will end up with the current model offering increasingly developing world treatment to the majority, with only those who can afford them having access to modern effective drugs.Anne BraithwaiteLeeds
Proper support for industryProper support for industry
You are right to highlight the importance of Britain’s motor industry to our economic future (“Nissan throws UK a Brexit lifeline”, News) but you miss the key point: what matters most is our capacity to design world-beating products and dominate major markets. For example, 5,000 people still work at Ford of Europe’s design centre at Dunton in Essex, but Ford gave up making commercial vehicles to Italy and Turkey and transferred Fiesta production to Spain. As part of a global company, it will be concerned with attracting and retaining first-class staff and Brexit sends all the wrong signals.You are right to highlight the importance of Britain’s motor industry to our economic future (“Nissan throws UK a Brexit lifeline”, News) but you miss the key point: what matters most is our capacity to design world-beating products and dominate major markets. For example, 5,000 people still work at Ford of Europe’s design centre at Dunton in Essex, but Ford gave up making commercial vehicles to Italy and Turkey and transferred Fiesta production to Spain. As part of a global company, it will be concerned with attracting and retaining first-class staff and Brexit sends all the wrong signals.
When I researched the role of Germany’s Fraunhofer research institutes for the book Good Cities, Better Lives, I discovered they are government-funded to support leading German manufacturers, not to keep universities going. One of the main centres is in Stuttgart, the home of Mercedes. Similarly, the city of Leipzig told me they built a motorway south of the city to secure BMW’s new plant.When I researched the role of Germany’s Fraunhofer research institutes for the book Good Cities, Better Lives, I discovered they are government-funded to support leading German manufacturers, not to keep universities going. One of the main centres is in Stuttgart, the home of Mercedes. Similarly, the city of Leipzig told me they built a motorway south of the city to secure BMW’s new plant.
Until our cities are enabled to support companies that have the capacity to design and make high-value products with both research and good housing, we are in race to the bottom.Dr Nicholas FalkChair, Urbed Trust, ManchesterUntil our cities are enabled to support companies that have the capacity to design and make high-value products with both research and good housing, we are in race to the bottom.Dr Nicholas FalkChair, Urbed Trust, Manchester
Don’t wait to plan your funeralDon’t wait to plan your funeral
Angela Neustatter (Comment) wants her ashes to stay with her family instead of going to a lonely graveyard. I have opted for a natural burial in a woodland and to have a rowan tree planted over me so I can indirectly continue to feed the birds for some time to come, and for my grave to be a spot of quiet reflection for anyone who chooses to visit. I would not wish to impose myself as an “ornament” on the mantelpiece of my children’s home, nor would I want my remains to be inadvertently spilt and lost in the vacuum cleaner with the rest of the dust.Angela Neustatter (Comment) wants her ashes to stay with her family instead of going to a lonely graveyard. I have opted for a natural burial in a woodland and to have a rowan tree planted over me so I can indirectly continue to feed the birds for some time to come, and for my grave to be a spot of quiet reflection for anyone who chooses to visit. I would not wish to impose myself as an “ornament” on the mantelpiece of my children’s home, nor would I want my remains to be inadvertently spilt and lost in the vacuum cleaner with the rest of the dust.
I agree we are all too precious about death these days. Perhaps it’s my age, but I am quite enthusiastic about planning my funeral and burial, but was sad that sending a photo of my natural burial plot to my sons, to show them what a lovely place it was, was met with a shiver of “let’s not think about that now”. We all have to face up to reality eventually.Carol LincolnLeicesterI agree we are all too precious about death these days. Perhaps it’s my age, but I am quite enthusiastic about planning my funeral and burial, but was sad that sending a photo of my natural burial plot to my sons, to show them what a lovely place it was, was met with a shiver of “let’s not think about that now”. We all have to face up to reality eventually.Carol LincolnLeicester
Rights of cohabiting parentsRights of cohabiting parents
Your article headlined “High court to rule on right to a civil partnership”, (News) was not correct in stating: that “Although many people believe that people in ‘common law marriages’ have rights over children and property protection, there is no such provision in law.” There is such provision in Scotland. Since 4 May 2006, fathers named on their children’s birth certificates here have exactly the same parental rights and responsibilities as mothers. Equal rights can also be conferred by agreement or through a court. From the same date, cohabiting couples have the right to make financial claims on separation or on the death of their partner. Their rights are not the same as for married couples, or those in civil partnerships, but Scots family law has made a significant step towards fairness for cohabitants.Elizabeth WelshElizabeth Welsh Family Law Practice, AyrYour article headlined “High court to rule on right to a civil partnership”, (News) was not correct in stating: that “Although many people believe that people in ‘common law marriages’ have rights over children and property protection, there is no such provision in law.” There is such provision in Scotland. Since 4 May 2006, fathers named on their children’s birth certificates here have exactly the same parental rights and responsibilities as mothers. Equal rights can also be conferred by agreement or through a court. From the same date, cohabiting couples have the right to make financial claims on separation or on the death of their partner. Their rights are not the same as for married couples, or those in civil partnerships, but Scots family law has made a significant step towards fairness for cohabitants.Elizabeth WelshElizabeth Welsh Family Law Practice, Ayr
Children and speed-readingChildren and speed-reading
I am uncertain if pupils need to read every word in a book once they become proficient (“The real truth about boys and books”, 23 October and Letters). For example, Kenneth Grahame’s classic, The Wind in the Willows contains an allegorical chapter titled, The Piper at the Gates of Dawn, which many boys and girls might well ignore. John Steinbeck once asserted that if readers considered some of his passages or chapters to be either self-indulgent or too wordy they should miss them out. He called such writing “hooptedoodle”.Geoff FenwickSouthportI am uncertain if pupils need to read every word in a book once they become proficient (“The real truth about boys and books”, 23 October and Letters). For example, Kenneth Grahame’s classic, The Wind in the Willows contains an allegorical chapter titled, The Piper at the Gates of Dawn, which many boys and girls might well ignore. John Steinbeck once asserted that if readers considered some of his passages or chapters to be either self-indulgent or too wordy they should miss them out. He called such writing “hooptedoodle”.Geoff FenwickSouthport