Apr 17, 2002
The Herald (United Kingdom)
PLANS by Greater Glasgow NHS board to improve services for patients with chronic neurological diseases are being threatened by the cost of ''ineffective'' drugs like beta-interferon, its director of public health said yesterday.
Dr Harry Burns's attack on the drug industry followed a paper tabled to the board in which he said few health authorities had developed coherent services for people suffering from head injury, epilepsy, multiple sclerosis, Parkinson's and Huntington's disease.
Services being introduced by Glasgow include specialist training for primary care teams in the management of epilepsy and MS, the recruitment of six nurses specialising in Parkinson's, epilepsy and MS, and two physiotherapists specialising in MS.
Money is also being provided to organisations which provide support services for Huntington's, MS and epilepsy patients.
But Dr Burns said: ''The financial self-interest of the pharmaceutical industry has the power to derail this work. It seizes on things like beta-interferon and forces us to invest in ineffective therapies at the expense of these important services.''
His attack follows an agreement reached in February between the NHS and the companies who manufacture the different forms of beta-interferon to make it available on a ''shared risk'' basis.
Backed by Malcolm Chisholm, the Scottish health minister, the scheme means that the (pounds) 8000-a-year cost of the drug will be reduced if it proves ineffective. The beta-interferons have been shown to provide relief for some patients , but it does not work for all of them and it has been difficult until now to predict who would benefit.
Scotland has one of the highest rates of MS in the world, an estimated 180-200 cases per 100,000 population, but a damning report commissioned by the Scottish Executive in November 2000 said it had the worst-funded services in Europe, with potential sufferers having to wait 14 months for diagnosis.
Mark Hazelwood, director of the Multiple Sclerosis Society in Scotland, said: ''All these developments by Glasgow are very welcome, but we have always said it should not be an either-or thing.
''People need access to disease-modifying pharmaceutical products and we are glad people will have access to them, and to other developments of the sort Greater Glasgow are looking at and have already set in train.''
Glasgow had at least gone part of the way, but there was still a long way to go. For example the best ratio of MS specialist nurses was in Forth Valley, with one per 500 patients. In Glasgow it was one per 1850.
''There should be three-and-a-half specialist nurses to bring Glasgow level, and we are getting two. I suppose by current standards that's not bad.''
Mr Hazelwood added: ''The whole thing about the risk-sharing scheme is that it makes the drug available on a more cost-effective basis. If it is ineffective, as Harry Burns suggests, then the price paid by the NHS will come down.
''That is the basis of the deal, granted that there are still technicalities
to be sorted out, like how long it takes to assess its effectiveness, and
how quickly the price reduction follows on.''
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