The views of patients and the general public about expensive anti-cancer drugs in the NHS: a questionnaire-based study

Abstract

OBJECTIVES: To determine the views of patients and members ofthe public about who should pay for expensive new cancer drugsnot recommended by the National Institute for Health andClinical Excellence (NICE). DESIGN: A study-specificquestionnaire was used to elicit the views of patients and thegeneral public between April and June 2010. It examinedwhether participants thought patients should be told about allpossible cancer treatments, if the NHS should always fundnon-NICE recommended drugs and attitudes towardsself-funding/co-payments. The influence of sociodemographicfactors on responses was also examined. SETTING: Oncologyclinics in Sussex and various locations including old persons'lunch clubs, parks, sports venues and support groups.PARTICIPANTS: Two hundred and 10 patients with common solidtumours, and 416 members of the general public MAIN OUTCOMEMEASURES: Frequencies of responses to items regarding paymentsfor expensive anti-cancer drugs stratified by sociodemographicfactors and comparison of responses between patients andmembers of the public. RESULTS: Most respondents (70%[147/210] of patients and 64% [266/416] of the generalpublic) had heard of NICE. Both groups believed that doctorsshould tell patients about all available cancer treatmentseven if the NHS cannot pay (94%, 196/208; 93%, 388/415).However, only 49% (101/207) of patients and 36% (146/409) ofthe public believed that the NHS should always fund all newcancer drugs that have failed health technology assessments.Strong predictors of willingness to purchase expensive newcancer drugs included younger age (<45 years), sex (female)and higher educational level. CONCLUSION: The generalpopulation appear realistic about the difficulties ofproviding funding for expensive new drugs. A communicationskills training course has been developed to help clinicianswith these difficult consultations.