Top-up payments for pricey drugs weighed

By Ben Hirschler

LONDON (Reuters) - Britain may soon allow top-up payments for costly cancer drugs within the state health service in a potentially divisive move highlighting the dilemmas facing cash-strapped social healthcare systems worldwide.

Mike Richards, the country's National Cancer Director, is due to deliver a report into "co-payments" this month and is expected to say top-ups should be allowed in limited circumstances.

A government spokeswoman confirmed his proposals would come in October but declined to comment on the content.

Allowing top-up payments would be a jolt to the 60-year-old National Health Service (NHS), which currently prevents patients paying privately for treatment. Those seeking to pay are typically denied any free NHS care and critics fear allowing top-ups would introduce a two-tier service.

Yet top-ups offer a solution to cases where the National Institute for Health and Clinical Excellence (NICE) judges drugs not to be cost-effective, even though they may extend life.

The issue has come to a head in cancer, where modern targeted drugs offer improved outcomes over older chemotherapy -- but at a cost of thousands of pounds a year.

The reluctance of the NHS to endorse many of these products has led to high-profile cases of terminally ill patients being denied free care after buying their drugs privately.

People familiar with the Richards' review said he was likely to back some provision for top-ups while at the same time trying to make them the exception by recommending new mechanisms to bring down the cost of pioneering new drugs.