July 20th, 2009 | 
Author: medical insurance has been paying for the miracle drug Herceptin which has been used by several breast cancer victims after the NHS declined to give them Herceptin.
Recently BUPA has given Herceptin to around one hundred women who were diagnosed as being in the early stages of the lethal HER-2 positive type of breast cancer. Standard Life has at the same time reportedly paid for the same drug in 30 cases in the early stages of breast cancer. And since last year Norwich Union has also given for Herceptin in initial stage cases.
Lately two ladies with initial stage breast cancer went to the High Court in an effort to obtain Herceptin for treatment via their health trusts. The predicament is that Herceptin is so costly. It costs more than twenty thousand pounds for a year on Herceptin and many impoverished trusts have basically refused to find the money for the drug, even though Patricia Hewitt the the Secretary of Health, has told them to make it accessible if doctors believe it will help.
The drug is used after surgery, radiotherapy and chemotherapy to avoid the reoccurrence of HER-2 positive. In subsequent years the drug has been used by the NHS for women with late-stage cancer. But , Roche, its manufacturer has just lately applied to the National Institute of Health and Clinical Excellence for its consent to use the drug in initial stage cases.
Mrs C M from Manchester was seven months’ pregnant when she first noticed she had a lump in her left breast. ‘My Doctor first thought the lump was a blocked milk duct’, she said. But after she had had the baby it didn’t go away,so during a routine check-up she mentioned it to the Doctor. She was then sent to a specialist.
The consultant diagnosed her with HER-2 positive breast cancer, but she lives in Wales a vicinity where Herceptin was not supplied by the local health trust. Fortunately for her she had medical insurance through BUPA which was prepared to pay for the treatment on her consultants suggestion.
She says, ‘If I’d been told I couldn’t have it, I would have been devastated. At a moment in time when you are in shock and fighting to get well, you don’t need another struggle for the best medicine to help you.’
There is a chance that Herceptin could cause heart failure, so Bupa is carefulcautious to fund the drug only when the resolution to use it has been made together with the patient and her consultant. A representative from Bupa said: ‘Many drugs have possible side effects. We never make a decision to permit any particular treatment without getting proof of its probable benefits. We now think that we have made an appropriate analysis. And other private health companies have come to the same conclusion – branches of the NHS have now decided to pay for Herceptin in the first stage of HER-2 positive breast cancer.’
But not all health insurance companies will cover the cost of Herceptin. Axa PPP says: ‘Our policies provide for the treatment of serious conditions which are expected to respond swiftly to drugs. With cancer, this may include surgery, radiotherapy and chemotherapy. Our company will not pay for treatment where there is no proof of it being effective. For this reason we do not pay for the use of Herceptin treatment of breast cancer that has not escalated (that is the cancer remains a primary disease). AXA is conscious of new trials with Herceptin for treating primary breast cancer, but this evidence has yet to be wholly considered by the National Institute for Health and Clinical Excellence so it has not been subject to full scrutiny.
Bupa advocate that ladies who want to make certain they are fully covered for the use of Herceptin should ask their health insurer the following five questions:
1. Will they cover you for secondary cancer (ie, if I get breast cancer and it then spreads to your lungs)?
2. Will the private medical insurance cover you for all stages from diagnosis through to treatment?
3. What professional accreditation does the treatment need to make sure that you are diagnosed and taken care of?
4. Will they cover you to use Herceptin for both the initial and late stages of cancer? If yes,for how long would this go on?
5. At what point would the insurance company stop paying for cancer care
This article has been written for publication by Brokers Online. Brokers Online offers uk residents access to many different kinds of financial products including life insurance and personal loans.
Brokers Online aims to provide its clients with a huge resource of financial information including helpful articles and Frequestly Asked Questions. If you cannot find the answer to your question feel free to post a question on our weblog.
Posted in social