Public cancer patients left behind in two-tier health system
Leading oncologist’s first question is now “Do you have health insurance?”
Friday 22 November: The Irish Cancer Society is warning that Ireland’s two-tier health system is failing public cancer patients, and they aren’t getting the same potentially lifesaving cancer treatments as those being treated in private hospitals. Private patients have swift access to EMA approved anti-cancer drugs. But public patents must wait on average two years to find out whether they will gain access to the same treatment.
According to Dr. Michael McCarthy, Consultant Medical Oncologist at University Hospital Galway, around 30-40% of new groundbreaking European Medicines Agency-approved cancer drugs available in private hospitals are not available to public patients in Ireland right now. For a cancer drug to be available to all patients, it must be approved by the HSE and made available through Ireland’s drug reimbursement scheme, a lengthy process which on average takes two years.
Cancer patients today do not have two years to wait. The Irish Cancer Society is urging the next Government to fully fund the National Cancer Strategy on a multi annual basis and improve access to new, groundbreaking treatments.
Dr. Michael McCarthy says that in his speciality (head & neck and gynaecological cancers) there are now six cancer treatments that he cannot prescribe to his public patients, which are available to private patients.
Speaking today Dr. McCarthy said, “Increasingly, the first thing I ask a cancer patient is, ‘Do you have health insurance?'. When I see a new patient, or an old patient whose cancer has progressed, until now my job has always been to identify the best possible treatment option for them and then to organise that treatment. However, now my main concern is which cancer treatments I can possibly access for them.
“I was driving to Mayo yesterday, listening to the radio. It seems there are many worthy causes seeking public funding and getting political promises with the election coming up. I have not heard of any politicians expressing an interest in addressing the two-tiered cancer drug access issue. Every day I see patients who are being left behind, patients who cannot access potentially lifesaving treatments, simply because they don’t have medical insurance.
“The disparity in treatments available is worsening, and as far as I can see, the public-private access divide will continue to widen as things stand. It is troubling, numbing to see some patients get access to the latest standard-of care treatments while for others all I can offer them is the second-best treatment available. It is a new departure in Irish healthcare that public patients cannot access cancer therapies that are available for in private hospitals. Second best cancer treatments today are typically treatment options that are now 20 years or more old. But that is the reality for 1 in 2 patients who don’t have medical insurance.
“The gap is widening on what the European Medicines Agency considers an acceptable treatment option, and what I am allowed to prescribe in public hospitals. It is up to the pharmaceutical companies to apply for reimbursement, and many don’t, as well as that some drugs progress through the system and are not approved for reimbursement at all. Public patients will never have access to those drugs. Public cancer patients are really being left behind”.
In February 2023, the Department of Health issued a review of the drug reimbursement process in Ireland. Recommendations included increased staffing to improve the efficiency of the reimbursement process, a publicly available tracker with indicative timelines to increase the transparency of the process, and to develop service level agreements between the different groups involved in the process.
The Department of Health established an internal Implementation Group and is working on these recommendations. But the Irish Cancer Society warns that more must be done both nationally and at a European level to accelerate equal access to cancer drugs for patients in Ireland.
Irish Cancer Society CEO, Averil Power said: “Cancer patients can’t wait, yet across the country they are forced to wait for potentially lifesaving treatments. It’s incredibly unfair that some patients are getting the latest, groundbreaking cancer treatments and others are being left behind.
“We’re urging the next government to give cancer patients the time they deserve by investing in the National Cancer Strategy and improving access to new, groundbreaking treatments. There is a two-tier health system emerging in Ireland, it shouldn’t be this way. We believe by working with industry and at a European level, the next Government can deliver equitable cancer care for every person in Ireland.”
Anyone with questions or concerns about cancer, can contact the Irish Cancer Society Support Line on Freephone 1800 200 700.
ENDS
For further information, contact Irish Cancer Society communications: communications@irishcancer.ie / 0876453867
Notes to Editor:
· 30-40% figure source – Michael McCarthy- Chair of the NCCP Medical Oncology Leads Group.
