People who have taken out private medical cover are being advised to hang on to their policies in spite of new funding for drugs on the National Health Service (NHS).
Cancer patients in England will, from next April, be offered greater access to treatments that their doctors recommend, following a £50m injection of cash into a Cancer Drugs Fund from the Department of Health.
Andrew Lansley, health secretary, this week also confirmed that a further £200m a year in funding would be available for cancer drugs from April 2011 to the end of 2013.
Cancer drugs are not made freely available on the NHS because they are deemed not to be cost effective and can cost tens of thousands of pounds if bought privately.
But the coalition government expects the Cancer Drugs Fund will help thousands of patients get increased access to innovative new cancer drugs that patients may have previously paid for out of their own pockets or claimed on their insurance.
“This £200m a year funding over three years for cancer drugs is a crucial step forward in addressing the disparity in patients’ access to cancer drugs in England compared to other countries,” said Mr Lansley.
“I want to give them more control over their healthcare.”
The shift in government policy could mark another turning point for insurers who have continually remoulded their cover to “plug the gaps” in NHS treatment.
Insurers have been competing more fiercely on their cancer cover benefits, offering payments for life extending or life saving chemotherapy drugs not routinely funded by the National Health Service (NHS).
But policyholders who view the emergence of the fund as an opportunity to trim elements of their cover, or even switch policies, were advised to proceed with caution.
“Most policies do not yet allow policyholders to strip out cancer cover,” says Andrew Tripp, chairman of the Association of Medical Insurance Intermediaries (AMII).
“I would caution policyholders from relinquishing their cover in haste as they may find it much tougher to find an equivalent policy, particularly if their health has worsened since taking out their original PMI.”
Some insurers said that the rollout of the Cancer Drugs Fund in coming years could alter policyholder demand for cancer benefits. “We do not currently have a ‘no cancer’ option on our policies,” says Axa PPP Healthcare.
“(However) we will be following the Cancer Drugs Fund development and we will see whether it significantly affects consumer demand for a ‘no cancer’ medical insurance option.”
“As the Cancer Drugs Fund has only recently been established, it’s too early to tell whether it will affect our policyholders’ claims for treatment of cancer,” Axa added.
However, other providers said this week that their propositions would not be weakened by the pledge to boost state funding for cancer drugs.
“We have not made any changes to our cancer benefits as a result of the Cancer Drugs Fund,” said Dr Johann Carinus, assistant medical director with Bupa Health & Wellbeing UK.
“Our cancer cover is one of the most extensive in the UK and we continue to cover our members for every step of their cancer journey, including secondary cancer.
“When a specialist recommends a new drug for a Bupa member, provided it is licensed by the European Medicines Agency for the condition being treated, Bupa will routinely pay for it.”
Western Provident Association (WPA) offers the UK’s only NHS Top-Up health cash plan which allows its policyholders to boost their core cover with £50,000 of cancer drugs benefits.
The not-for-profit insurer said its cancer drugs benefit was still a worthwhile safety net for policyholders.
“NICE [the drugs rationing body] guidelines and regional variations mean that access to expensive cancer drugs is a lottery which our cancer drugs benefit aims to fill,” said WPA.
“As an extra benefit within NHS Top-Up, costing £4.20 a month, it is great value and relevant to those who worry about the aspirations of the NHS to be all things to all people.”
A consultation on how the Cancer Drugs Fund will operate from April was launched this week and runs until mid-January next year. While this is underway, cancer charities are cautioning that there could still be issues for patients in getting equal access to extra funding.
“We warmly welcome the Cancer Drugs Fund which means that patients should be able to benefit from the treatments their clinicians feel could benefit from them,” said Andrew Wilson, chief executive of the Rarer Cancers Foundation.
“It is critical that the fund is administered in such a way that minimises bureaucracy and avoids unjustifiable variation, otherwise public confidence in the policy could be undermined. For these reasons, we believe that a national approach to the fund would be best.”
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