The patient, FGR, begins this afternoon a cycle of radiotherapy at the Central University Hospital of Asturias (HUCA). His situation, according to his family, “is very delicate”, so “We do not understand such a delay when the specialists who take my husband are so clear that what they propose is the only viable solution to save his life.”
In the background of this situation is the Commission for the Rational Use of Medicines and Health Products of the Principality (CURMP). This entity is responsible for analyzing the requests made by doctors to prescribe, to a specific patient, treatments that are not yet approved by the Ministry of Health and standardized in the national territory.
As in so many other cases, what the doctors who take this patient are asking for is a drug for what is called “compassionate use”. To the layman in medicine it may be shocking, but in this area discrepancies may arise between specialists. So that, what some see clear, others do not see it as much or consider it inappropriate. In this type of tug of war there may be at least two relevant circumstances. On the one hand, the price of new drugs is usually high, so the cost-effectiveness balance is scrutinized. On the other hand, there is that factor that generates so many and so varied discords: inequality between autonomous communities. Each has its commission for the rational use of drugs, and what one accepts as good another rejects.
There is that factor that generates so many and varied discords: inequality between autonomous communities; because each one has its commission for the rational use of drugs, and what one accepts as good another rejects.
In the case of FGR, the doctors proposed to apply “Regorafenib” to him in October 2020, but the CURMP rejected the request. As an alternative, last December they proposed to give him “Lenvatinib”, and to this day they still have no response. “Meanwhile, my husband’s situation deteriorates; this is exasperating, ”says his wife.
The intricate clinical history of the Gijonian patient has its genesis half a century ago. In 1970, he was seriously injured in a traffic accident on the outskirts of Oviedo. She was given several blood transfusions and she began to experience diffuse discomfort. In 1991, in a medical examination of his company, they detected a hepatitis C that the doctors attributed to the transfusions received two decades earlier.
“There began the ordeal, with controls and more controls, and bad news, one after another,” says his wife, who highlights that her husband “he was always strong and led a healthy life ”.
Hepatitis was degenerating into cirrhosis. In 2004 he began to be treated with “Interferon”. In 2012, he underwent a liver transplant, but “Hepatitis C was still in his blood,” says his wife. In 2015, they gave him the curative treatment for hepatitis C, a great revolution at that time, and the effect was favorable.
But the allergy was short. In 2018, he started with tumors in the liver and in October they had to remove a segment of the organ that had been implanted. In 2019, another three tumors developed in the liver and doctors had to perform a radioembolization to give him the necessary treatment.
In the spring of 2020, more tumors appeared, this time in a kidney and a vertebra. In June he started a treatment and in October it was verified that it was not working. It was the moment in which the doctors chose to request from the CURMP a therapeutic alternative not yet approved in Spain. The first request was denied; and the second has not yet been answered. “They tell us that it is not a question of money, and we believe it, but this wait is agonizing. And they assure us that there are more people in this same situation”, Emphasizes, between the anguish and the indignation, the wife of FG R