Mount Vernon Cancer Centre in London, England has become the first National Health Service (NHS) hospital to buy a CyberKnife machine, a new robotic radiosurgery system, but England’s specialized commissioning group (SCG) has banned NHS patients from being treated with the device.
According to Dr. James G. Schwade, executive director of the Cyberknife Center of Miami, the Cyberknife is a system for delivery of highly concentrated radiation to perform image-guided radiosurgery.
“The Cyberknife may be useful for many cancers, including primary and metastatic lung cancer, brain, spine, and other central nervous system tumors, and tumors in the liver, pancreas, prostate, and elsewhere,” said Schwade. “It is often useful in patients who have previously had other treatments and have persistent or recurrent tumors. But it is increasingly being used as a primary treatment in many sites, specifically prostate and lung cancer.”
Authorities Rule: Not Cost-Effective
Cancer sufferers from Bedfordshire, Hertfordshire, Essex, Norfolk, Suffolk, and Cambridgeshire have taken to the pages of England’s newspapers to complain about this decision. Although doctors may recommend the treatment for their patients, only private patients whose insurers agree to pay will have access to the devices—not those who have only traditional NHS coverage.
There are two CyberKnife machines now in use in the UK, both located at private hospitals in Harley Street, London, where patients pay more than £20,000 pounds for a course of treatment (roughly $30,000)
According to Trevor Myers, the SCG’s chief operating officer, its clinical advisory group (CAG) was given a presentation by some of Mount Vernon’s doctors about their Cyberknife machine, in an attempt to achieve approval.
“The CAG came to the conclusion that there is not enough evidence in regard to both the clinical and cost-effectiveness of the service. Given the limited resources in the NHS, it is vital that we buy services that have been proven to be clinically effective in accordance with national policy,” Myers said.
NICE Study in Progress
It is possible NHS could reconsider. In January of this year, England’s chief medical officer, Sir Liam Donaldson, asked the National Institute of Health and Clinical Excellence (NICE), which advises the NHS, to accelerate its study of which treatments represent value for money, including the assessment of the potential benefit of the CyberKnife.
According to a spokesperson for NICE, the institute intends to undertake a “fast-track” evaluation of the system and similar technologies, and it expects to report on its findings later this year.
Tabassum Rahmani ([email protected]) writes from Dublin, California.