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Private healthcare patients get exclusive access to cancer drugs

  • 14-04-2019 8:04pm
    #1
    Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    Oncologists will now be only able to prescribe new potentially life saving cancer drugs to private patients. I think this is pretty scummy to be honest. Nobody pays the full cost of medical treatment/research and I think it's really a false ideology to say some people "earn" the right to more healthcare than a poorer person.

    "Medical oncologist John Crown said he welcomes the move for VHI customers but is "personally very troubled by it".

    He said: "For the first time since I can ever recall, we have a difference in access to cancer drugs between public and private patients. It's completely unfair. It's going to be extraordinarily difficult now."


    https://www.rte.ie/news/health/2019/0414/1042590-cancer-drug/


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Comments

  • Registered Users Posts: 12,564 ✭✭✭✭whiskeyman


    Your wealth is your health...


  • Registered Users Posts: 6,168 ✭✭✭Ubbquittious


    It must be terrible to be the recipient of inferior drugs knowing full well that they are inferior and that you're getting them for cost reasons.

    If they took the nothing-doers out of the HSE there would be no need for this


  • Registered Users Posts: 124 ✭✭Touchee


    The way I read it is that these drugs were not available to anyone in the country. VHI is giving access to its customers, but the HSE has yet to add them to their cancer treatment list?

    Maybe it's a case that the HSE must be pushed to also adopt these drugs, as soon as possible, to avoid discrimination between private and public patients.


  • Moderators, Category Moderators, Science, Health & Environment Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 36,787 CMod ✭✭✭✭ancapailldorcha


    The article is quite vague and, frankly of very poor quality. I don't read RTÉ so I suppose I am not missing much.

    Nothing whatsoever is mentioned about these drugs save for that they are new. That's it. Are they drugs in the traditional sense, ie chemo? Or are they something else?

    In the UK, we have the National Institute for Clinical Excellence (NICE) which must approve NHS funding for all drugs. It makes decisions based on drug efficacy, safety and value for money as health spending is finite. I don't know what the Irish equivalent is but the fact that the author of this piece never contacted them or mentioned this suggests that this is a clickbait article. We don't know if these new drugs perform any better than generics of if they just add a few months to a patient's life. If they don't perform well then the HSE has a tough call to make as this money can be spent elsewhere where it might reap more benefits.

    A shame that RTÉ went for the clickbait article on such an important issue.

    We sat again for an hour and a half discussing maps and figures and always getting back to that most damnable creation of the perverted ingenuity of man - the County of Tyrone.

    H. H. Asquith



  • Registered Users Posts: 712 ✭✭✭Bitches Be Trypsin


    Clickbait article.

    I do believe though that having private health insurance should have some perks besides faster treatment and private rooms. Paying people should get superior treatment imo.


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  • Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    The National Centre for Pharmacoeconomics evaluates the cost effectiveness of new medicines, and those that are cost effective are then reimbursed by the state. Based on the data submitted to them, these drugs weren't deemed cost effective for the conditions outlined in the article. This is why they aren't funded by the state for public patients. Covering these medicines would mean taking funding from other areas of the health system where it provides more benefit.

    This is a dangerous precedent set by VHI, it's effectively subverting the national process for economic evaluation of medicines. It's effectively going to be a means for pharmaceutical companies to gain extra leverage in getting new medicines reimbursed at higher prices.


  • Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    Irish Times article on the same issue. The Irish Cancer Society and John Crown, Ireland's top oncologist have weighed in on this being unfair.

    https://www.google.com/amp/s/www.irishtimes.com/news/health/access-to-cancer-drugs-for-private-patients-incredibly-unfair-1.3860348%3fmode=amp


  • Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    Clickbait article.

    I do believe though that having private health insurance should have some perks besides faster treatment and private rooms. Paying people should get superior treatment imo.

    We already have a system where time to access treatment is based on ability to pay rather than medical need, which is scandalous enough. And you genuinely want there to be extra advantages for the wealthy? I'm glad most of our political parties disagree and have a strategy to move away from this two tier system.


  • Registered Users Posts: 1,137 ✭✭✭paddy19


    The real question, as highlighted by professor Crown, is what the hell VHI are at.

    The VHI have no expertise in evaluating cancer drugs.

    The drug companies use vulnerable cancer patients to try to blackmail higher prices from the taxpayer.

    They are helped by the media who think we should base drug approval based on patients experience rather than scientific data.


  • Moderators, Category Moderators, Music Moderators, Politics Moderators, Society & Culture Moderators Posts: 22,358 CMod ✭✭✭✭Dravokivich


    The article is quite vague and, frankly of very poor quality. I don't read RTÉ so I suppose I am not missing much.

    Nothing whatsoever is mentioned about these drugs save for that they are new. That's it. Are they drugs in the traditional sense, ie chemo? Or are they something else?

    In the UK, we have the National Institute for Clinical Excellence (NICE) which must approve NHS funding for all drugs. It makes decisions based on drug efficacy, safety and value for money as health spending is finite. I don't know what the Irish equivalent is but the fact that the author of this piece never contacted them or mentioned this suggests that this is a clickbait article. We don't know if these new drugs perform any better than generics of if they just add a few months to a patient's life. If they don't perform well then the HSE has a tough call to make as this money can be spent elsewhere where it might reap more benefits.

    A shame that RTÉ went for the clickbait article on such an important issue.

    Damn near all news media has descended to click bait now.


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  • Moderators, Science, Health & Environment Moderators, Society & Culture Moderators Posts: 60,014 Mod ✭✭✭✭Wibbs


    Kurtosis wrote: »
    We already have a system where time to access treatment is based on ability to pay rather than medical need, which is scandalous enough. And you genuinely want there to be extra advantages for the wealthy? I'm glad most of our political parties disagree and have a strategy to move away from this two tier system.
    HOpefully that remains the case K, unfortunately the "money", that is the insurance industry and those who benefit from it would only love to have everywhere set up like the US medical service, based on insurance and wealth. And they'll push hard for it. Look at pet insurance over the last twenty years since it snuck in. Vet bills have gone way up within the insurance framework and if you go off the books it goes pretty crazy to keep you on the books and compliant. Oh and vets aren't seeing much benefit back from it contrary to popular belief. The insurance industry hates public health and will lobby hard against it.

    Rejoice in the awareness of feeling stupid, for that’s how you end up learning new things. If you’re not aware you’re stupid, you probably are.



  • Registered Users Posts: 1,120 ✭✭✭MIKEKC


    Kurtosis wrote: »
    We already have a system where time to access treatment is based on ability to pay rather than medical need, which is scandalous enough. And you genuinely want there to be extra advantages for the wealthy? I'm glad most of our political parties disagree and have a strategy to move away from this two tier system.

    Just because you have private health insurance doesn't mean you are wealthy. For many it's a choice, some feel they shouldn't need it after paying PRSI . Others chose to spend their money in different ways


  • Moderators, Category Moderators, Politics Moderators, Recreation & Hobbies Moderators, Society & Culture Moderators Posts: 81,310 CMod ✭✭✭✭coffee_cake


    what do we know about the drugs? the IT suggests they may not work
    https://www.irishtimes.com/news/health/access-to-cancer-drugs-for-private-patients-incredibly-unfair-1.3860348
    i wonder if this is a price gouging exercise for vhi rather than an actual useful drug not being funded by the hse. if it is the latter, they should be told to get on it asap


  • Posts: 0 Kyler Late Putter


    paddy19 wrote: »
    The real question, as highlighted by professor Crown, is what the hell VHI are at.

    The VHI have no expertise in evaluating cancer drugs.

    The drug companies use vulnerable cancer patients to try to blackmail higher prices from the taxpayer.

    They are helped by the media
    who think we should base drug approval based on patients experience rather than scientific data.

    This poster gets what's going on precisely. Trace this story back and you'll find it's from one of the associated pharma companies attempting to use the media to put pressure on the Irish state to pay a higher price for their "essential" drug. The day journalists in our "free press" stop being self-serving, sycophantic bag boys for the agendas of the powerful will never happen.


  • Registered Users Posts: 23,333 ✭✭✭✭One eyed Jack


    Kurtosis wrote: »
    We already have a system where time to access treatment is based on ability to pay rather than medical need, which is scandalous enough. And you genuinely want there to be extra advantages for the wealthy? I'm glad most of our political parties disagree and have a strategy to move away from this two tier system.


    I didn’t read anywhere in the post you quoted where the poster suggested there should be extra advantages for the wealthy? There should be extra advantages for people who are willing to pay privately for their own healthcare, a system which our political parties are trying to make everyone move towards by putting additional levies on people who only choose to take out private health insurance in later life, in an attempt to make people take out private health insurance when they’re younger.

    One of the benefits private health insurance providers are able to offer to their customers is earlier access to innovative treatments. It’s not unfair when the person is paying for it, that’s how insurance works!

    Whether or not the Minister for Health decides to approve the early intervention treatments for public patients is entirely up to him, but simply suggesting it’s “unfair” that the treatments aren’t available on the public dime when it’s not cost-effective to do so, that’s not unfair when it’s exactly what people who choose to pay for private health insurance are paying for!


  • Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    OEJ, lifetime community rating was introduced in 2014, when the government's policy was to introduce universal health insurance. Since then, there's been cross-party agreement on the Sltecare strategy, to introduce universal health care and move away from the two tier system.

    I don't think access and timeliness of access to health care should be based on ability to pay, rather it should be based on medical need. I think it is extremely unfair that money should allow one to jump the queue when it comes to medical treatment.


  • Registered Users Posts: 23,333 ✭✭✭✭One eyed Jack


    Kurtosis wrote: »
    I don't think access and timeliness of access to health care should be based on ability to pay, rather it should be based on medical need. I think it is extremely unfair that money should allow one to jump the queue when it comes to medical treatment.


    I get what you’re saying, but the provision of medicine can’t just be based upon medical need, as it has to be paid for. That’s why we have bodies like NCPE and why the Orkambi fiasco was just that - the HSE simply can’t afford it, and it was an entirely politically motivated decision to pay for it.

    You keep saying that it’s unfair that when someone pays for better medical treatment that they have access to better medical treatment. In my view it would be unfair if people who weren’t willing to pay for private health care were able to access the same level of healthcare as those who have chosen to pay for it with insurance premiums.

    How does it sound fair to you that someone who has never paid for private health insurance would receive the same standard of healthcare as someone who has always paid their insurance premiums just in case they ever needed to avail of private healthcare?

    It’s not really jumping the queue, it’s paying for a better healthcare service than is offered by the public health system. I know that these practices are putting the Minister for Health over a barrel in a time when there are many people who expect all sorts without having to pay for it, but simply calling it “unfair” should never have the Minister reverse the decision not to pay over the odds for medical treatments when it isn’t economically viable to pay for them from the public purse, because that’s unfair - now not only am I paying more for some politicians idea of socialised medicine, I’m also still paying for private health insurance too. That’s unfair.


  • Closed Accounts Posts: 157 ✭✭Pretty Polky


    Money talks in this country. Simple as that.


  • Posts: 2,078 ✭✭✭ Brennan Brief Maiden


    Why the hell would you pay for private healthcare if there was zero advantage to it?

    I'd be quite happy to stop paying for healthcare if the public system was better as it's not cheap.


  • Posts: 2,078 ✭✭✭ Brennan Brief Maiden


    Money talks in this country. Simple as that.

    In every country.


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  • Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    bluewolf wrote: »
    what do we know about the drugs? the IT suggests they may not work
    https://www.irishtimes.com/news/health/access-to-cancer-drugs-for-private-patients-incredibly-unfair-1.3860348
    i wonder if this is a price gouging exercise for vhi rather than an actual useful drug not being funded by the hse. if it is the latter, they should be told to get on it asap

    It says they may not work for some people and work great for others. This is like a lot of drugs. Depending on your genotype you'll metabolize drugs differently. Some people do well on anti-depressents while some don't for example. Also these drugs are for late stage cancers where you really need to try anything you can. It would be the difference between life and death.


  • Posts: 13,712 ✭✭✭✭[Deleted User]


    Clickbait article.

    I do believe though that having private health insurance should have some perks besides faster treatment and private rooms. Paying people should get superior treatment imo.
    I'd have no problem with that, if private healthcare weren't already subsidised through the HSE and tax rebates for health insurance.

    If you want better treatment pay for it all yourself.

    As far as I'm concerned, the current model of health insurance should only be for increased comfort and perhaps slightly faster access to elective procedures.


  • Banned (with Prison Access) Posts: 13 WeIrishareEvil


    steddyeddy wrote: »
    Oncologists will now be only able to prescribe new potentially life saving cancer drugs to private patients. I think this is pretty scummy to be honest. Nobody pays the full cost of medical treatment/research and I think it's really a false ideology to say some people "earn" the right to more healthcare than a poorer person.

    "Medical oncologist John Crown said he welcomes the move for VHI customers but is "personally very troubled by it".

    He said: "For the first time since I can ever recall, we have a difference in access to cancer drugs between public and private patients. It's completely unfair. It's going to be extraordinarily difficult now."


    RTE doing a Daily Express here. Article says nothing. Nothing at all.


  • Registered Users Posts: 11,758 ✭✭✭✭BattleCorp


    paddy19 wrote: »
    The real question, as highlighted by professor Crown, is what the hell VHI are at.

    The VHI have no expertise in evaluating cancer drugs.

    The drug companies use vulnerable cancer patients to try to blackmail higher prices from the taxpayer.

    They are helped by the media who think we should base drug approval based on patients experience rather than scientific data.

    You do realise that these are proper drugs and have been tested and cleared for use. You are making it sound like the drugs haven't been evaluated. They have been cleared for use by the HPRA (Medicines Board).

    The VHI are an insurance company. They should have nothing to do with evaluating cancer drugs as they are unqualified to do that.

    Your gripe should be with the Government because the VHI are willing to pay for these drugs but the Government are not (yet).

    I will agree with you that these drugs are very very expensive but developing and testing drugs is a ridiculously expensive thing to do.


  • Registered Users Posts: 12,302 ✭✭✭✭mariaalice


    Its slightly click bait, the HSE does offer the drugs in some cases, however, the VHI is giving the consultant the option of prescribing it for any case they see fit.


  • Registered Users Posts: 582 ✭✭✭Hobosan


    I use €500 notes as plasters. Not even the best health insurance on the market can offer that service.


  • Registered Users Posts: 89 ✭✭ashes2014


    I am afraid that this practice will become more and more common.

    The public healthcare system will get worse and worse and we will all have to pay for private healthcare out of fear.


  • Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    RTE doing a Daily Express here. Article says nothing. Nothing at all.

    I linked two articles in this. The "nothing at all" people are proclaiming is based on an inability to look up further information or understand the facts involved.


  • Registered Users Posts: 27,564 ✭✭✭✭steddyeddy


    The British newspaper the Times are also weighing in on it.
    The former director-general of the HSE has described a two-tier drugs treatment system for cancer patients as “terrible” and said it will have a far-reaching impact.

    Last week oncologists learnt that certain cancer drugs known to help people with breast cancer and melanoma would be made available to patients with health insurance from VHI Healthcare. In a letter the insurer said it would provide its patients with access to the breast cancer drug Pertuzumab (perjeta) and immunotherapies such as Tecentriq (atezolizumab), Keytruda (pembrolizumab) and Opdivo (nivolumab).


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  • Registered Users Posts: 12,302 ✭✭✭✭mariaalice


    Interesting point, why can't the HSE procedure the drug through the VHI as the VHI has cut a deal with the drug company.


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