Top-Up Payments for Expensive Cancer Drugs: Rationing, Fairness and the NHS

29 Pages Posted: 10 May 2010

See all articles by Emily Jackson

Emily Jackson

London School of Economics - Law School; London School of Economics - Law School; Queen Mary University London - School of Law

Abstract

This article examines the implications for patient care, and for the future of rationing within the NHS, of the recent decision to permit NHS patients to supplement their care by paying for medicines — mainly expensive new cancer drugs — which are not available within the NHS. The starting point is the recommendations of the Richards' Report and their implementation through new guidance issued by the Department of Health and the National Institute for Health and Clinical Excellence. Practical challenges arise from the insistence upon the ‘separate’ delivery of self-funded medicines, and more flexible cost-effectiveness thresholds for end of life medicines may have repercussions for other patients. While undoubtedly part of the trend towards explicit rationing, top-up fees might also represent a significant step towards regarding the NHS as a core, basic service. Finally, the issue of top-up fees is located within the broader context of current cancer research priorities and persisting health inequalities.

Suggested Citation

Jackson, Emily and Jackson, Emily, Top-Up Payments for Expensive Cancer Drugs: Rationing, Fairness and the NHS. Modern Law Review, Vol. 73, Issue 3, pp. 399-427, May 2010, Available at SSRN: https://ssrn.com/abstract=1602186 or http://dx.doi.org/10.1111/j.1468-2230.2010.00801.x

Emily Jackson (Contact Author)

London School of Economics - Law School ( email )

Houghton Street
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020 7955 7256 (Phone)

London School of Economics - Law School ( email )

Houghton Street
London WC2A 2AE, WC2A 2AE
United Kingdom
020 7955 7256 (Phone)

Queen Mary University London - School of Law ( email )

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London, WC2A 3JB
United Kingdom

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