Recent debate by some healthcare policy makers about how the NHS should spend money for patients reaching the end of their life has argued it might be better to direct resources to improving the quality of life of people close to death rather than spending money on medicines to extend their life for a relatively short period of time. I fundamentally disagree with this view and there are a number of important reasons why.
We should never dismiss the extra time that medicines can give to terminally ill patients – a few months of extra life are of great value to both the patient and their family.
Different people react in different ways to treatment, and medicines can actually add many years to some people’s lives, even when it is predicted that it will only increase life expectancy slightly; and in future, personalised healthcare will help us determine those patients who are most likely to respond to treatment which will allow doctors to concentrate on those who would benefit from a medicine while sparing unnecessary intervention for those for whom a treatment would prove ineffective.
It is vital we remember that end of life medicines are very often the cornerstone of a whole new series of innovative medicines that can deliver much longer term treatments for a particular disease – a case in point is HIV.
The first HIV treatments in the 1980s were largely used to fight off the symptoms of the disease and extend the life of sufferers, even just for a short time. These treatments were expensive but the huge initial investment allowed extensive scientific research to start the development of medicines that now effectively make HIV a chronic disease, rather than a terminal one. In fact many of the treatments we now have for HIV as well as many other diseases are inexpensive and cost very little to produce because they are available on the generics market. So not only does the upfront investment for end of life medicines allow for significant advance in patient health, in the long run it reduces the cost of healthcare.
I understand that NHS budgets are under pressure more now than perhaps any time, but channelling money away from end of life medicines is a false economy that will cost the healthcare system more in the long run and hinder the discovery of medicines that can transform lives.
ABPI Chief Executive