Tuesday, 27 November 2012

Guest blog: My moustache is almost in full bloom

This week we have a guest blogger. Patrick Taggart, long term supporter of Prostate Cancer UK and veteran Mo Bro who has a personal experience of prostate cancer, talks about his Movember journey.

My moustache is almost in full bloom

Friends and acquaintances are giving me funny looks. Nothing new there, but this time at least it’s all in a good cause. My philtrum is getting fuzzy. In other words, I’m growing a moustache for Movember. I’m being joined by Mo Bros (and Mo Sistas) all over the world in a campaign to raise vital funds and awareness for men’s health, specifically prostate and testicular cancers.

Men are notoriously reluctant to address important health issues. Back in 2004 I, like many men, was not in the habit of visiting my GP. In fact, I didn’t even know his name. Only after I had accumulated an impressive array of ailments – among them a dodgy back, sore knees and difficulty sleeping because of the need to keep getting up to pee – did I get round to visiting him. My first surprise, when I walked in, was that ‘he’ was a ‘she’ – which pretty much summed up how up to speed I was with my health care arrangements! My second surprise was that she was dismissive of most of my ailments but was very interested in my frequent night-time visits to the loo. She referred me to a urologist. Had she not done so, my prostate cancer might have gone undiagnosed for a long time.

Movember is doing a wonderful job of raising the profile of prostate and testicular cancers in the media. On an inter-personal level, the sprouting of a moustache on a normally fuzz-free face provides a great opener for a conversation about men’s health. I hope that, as a result of Movember, more men with symptoms of prostate trouble will understand the significance of those symptoms and visit their GP without delay.   
Movember also raises much-needed funds. A large proportion of these funds will go towards research.  As someone who has lived through diagnosis and treatment for prostate cancer, the need for research is very obvious to me.

Despite the prompt action of my GP in 2004 my cancer evaded detection until 2009. I have no complaints about my urologist. He monitored my rising PSA closely and carried out three prostate biopsies, all without detecting the tumour. It was only after the third negative biopsy, with my PSA still rising, that he found the tumour by means of a trans-urethral resection (TURP) of the prostate.

Thankfully, I appear to be cancer-free today, but some men aren’t so lucky; a delayed diagnosis could mean a shortened life! Research to improve diagnostic methods is vital.

After diagnosis, my treatment consisted of a radical prostatectomy in 2009 followed by salvage radiotherapy in early 2011. The treatments were successful, but I did not emerge unscathed. It’s wonderful to be alive but, given the choice, I would - of course - prefer not to have been left with urinary, bowel and sexual problems. There are novel treatments promising fewer side-effects, but more research is needed to confirm their long-term efficacy.  Better diagnostics and finding effective treatments with fewer side-effects are just two of many priority research areas.
My moustache is almost in full bloom but, sadly, I look nothing like Tom Selleck and women are not throwing themselves at me. I knew I would look completely ridiculous, having taken part in Movember last year. But looking ridiculous is a small price to pay for being able to participate in such a worthwhile campaign.

Patrick Taggart.

Tuesday, 13 November 2012

Putting patients first: why people affected by cancer should be involved in value-based pricing

I may often sound like a broken record on this blog when it comes to challenging the health inequalities facing men in the UK, but accessing effective drugs on the NHS is one issue that affects us all.

The current system of drug pricing and evaluation has many benefits, including keeping drug prices relatively low compared to other countries but it does leave a lot to be desired. We know, for example, that the UK is often slower than other countries at taking up new cancer medicines. We also know that appraisal bodies such as the National Institute for Health and Clinical Excellence (NICE) and the Scottish Medicines Consortium (SMC) focus heavily on the cost-effectiveness of drugs. I have no problem with drugs being rejected because they aren’t clinical effective, – why should the NHS pay for drugs that don’t work? I recognise the current financial restraints the NHS is under and have personal experience of managing ever decreasing NHS budgets, but new treatments for all diseases will continue to be developed and we must have provision to be able to adopt them in the UK. If we are to have a world-class NHS and the best outcomes for patients, we need to invest in the most effective treatments.

Currently, under the Pharmaceutical Price Regulation Scheme (a policy which has been in place since 1957), drug companies set the original price of a drug and restrictions are placed on price increases and how much profit they can make from selling the drug to the NHS. Once the price is set, drugs are assessed (by NICE, the SMC or the All Wales Medicines Strategy Group) for their clinical and cost-effectiveness before being approved or rejected for use on the NHS.

From 2014 all new branded drugs will be subject to a new process called value-based pricing, which will involve setting prices on the perceived value of a drug rather than its actual cost. This change represents an opportunity to move away from an unwieldy system that delays access to life-extending drugs, results in inequalities in access to new medicines and relies on safety nets and contingency plans such as the Cancer Drug Fund in England. This is an exciting prospect and we welcome the principles behind the Government’s proposals, but we must ensure the switch to value-based pricing leads to a vast improvement of the current system, or it will simply be a waste of time and money.

Although value-based pricing is scheduled to be introduced in 2014 (just 14 months away), not enough has been done to consult the most important group of all: patients. Having identified this rather worrying gap in the development of value-based pricing, Prostate Cancer UK pledged to bridge it, and commissioned a report detailing the views of people affected by cancer. Who better to help develop the system of drug evaluation and help define value than the very men and women for whom the process is designed to benefit?

Our reportValue-based pricing: Getting it rightfor people with cancerpublished today in partnership with thirteen other leading cancer charities, shows that people affected by cancer want to have an equal role in designing the value-based pricing system. Their views and opinions also highlight the need for a new method of involving patients in the process of drug appraisals to ensure their views can be heard sufficiently.

In addition to placing a high value on drugs which offer clear clinical benefits, our research shows that people value drugs which provide quality of life improvements such as reducing pain and fatigue. People affected by cancer have also expressed their belief that drugs which give people nearing the end of their lives precious extra time should be given a high value. The report also identifies the increasing worry that focusing on the value of the societal benefits of drugs – such as getting people back to work – could disadvantage many people with cancer who may have already retired, are too unwell to ever re-enter the workforce or are children or young people still in education or training.  

The views of people affected by cancer should be integral to determining how value-based pricing will work. I have had an initial conversation on our report with the Chief Executive of the ABPI and we will be going to present the key findings at their HQ next week.  We have also sent copies of our report to  the Department of Health I and look forward to hearing their views in the near future. I’ll let you know what they say.

Thursday, 1 November 2012

Time to welcome back a furry friend

I can hardly believe that it is time to welcome back a furry friend (or should that be fiend) back into my life. Today is 1st Movember and I will of course be fully participating. Last year I was a ‘Mo virgin’ – unaware how it would look or feel to be the ‘proud’ owner of a top lip warmer. Well now I am a ‘Mo pro’ I enter this most important month of the year with the certainty that my facial hair will be ginger (although I prefer to think of it as ‘strawberry blond’). However, the main source of my excited anticipation is the knowledge that I will be taking part in something really special that genuinely brings together Mo Bros and Mo Sistas to make a real difference for the health of men.

I cannot quite believe it has been a whole year – so much has happened. The charity has become Prostate Cancer UK and has a new look and feel as well as creating a unified voice through our merger with Prostate Action. It is our partnership with Movember that has enabled us to drive these changes forward and to be clear about our ambitious plans for the future that underpin our recently published MANifesto. We are also entering Movember with new partnerships with the Football League and Royal Mail, both of which will lead to more Mo Bros raising money and spreading the vital messages about why we are all looking a bit daft (or very daft in my case).

This year, the campaign is all about ‘Movember and Sons’ and it has such a strong resonance with everything that Prostate Cancer UK is all about. Prostate cancer is currently the most common cancer in men and it will not be many years before it is the most common of all cancers. This is why in our MANifesto we have committed to significantly increasing investment into both supporting men with the disease and developing research to identify better forms of diagnosis and treatment. These commitments are in no small part down to the fund raising efforts of Mo Bros and Mo Sistas.

As well as raising money, Movember is all about promoting awareness of prostate cancer and other men’s health issues. Simply by wearing their Mo with pride, Mo Bros are responsible for millions of conversations about men’s health in the UK alone. When you consider that Movember is a truly global campaign that translates to billions of conversations. That is why is so fantastic that this year's campaign recognises the importance of those conversations happening across generations. Talking to your dad, uncle or boss has real potential to save lives. This is also exactly why the third theme of our MANifesto is to lead change. Change will not happen until we start talking about prostate cancer and create a genuine men’s health movement that is driven by our belief that it is an issue that has been neglected for too long and it is time to be clear that men deserve better.

I am looking forward to the month ahead because Movember is fun. I am looking forward to it because it is great to know that you are part of something big that gets so many people taking notice of such an important issue. I am even looking forward to it because I have missed my Mo, it will be good to have him back.