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Cancer treatment unavailable in UK

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Posted

A friend of my girlfriend is living in the UK and was diagnosed with lung cancer. Her oncologist suggested to treat her with a drug which is not available in the UK for that indication (or at least will not be paid for by the NHS) and is very expensive (EUR 7600 per month), so she cannot afford it. In Germany the drug is available. Could she (as a EU-citizen) come to Germany and get treatment here (i. e. get a prescrition) without having to completely move and leave her family (husband and 9 year old daughter) behind? In other words: Would the NHS reimburse the cost for drugs prescribed by a German doctor even if they are not recognized in the UK for a specific indication?

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Posted

Sorry that I can't help you with more specific information, but here are some links that I found:



  • here, that's the NHS section on treatment abroad, and
  • here is the web site of the European Commission on "Planned treatment in another EU country"

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Posted

I have personal experience of this, though not for cancer (I've had a headache all day every day since the 16th October 2010) and when we were all out of treatment options on licensed drugs in the UK, I was given a private prescription for a drug used all over Europe, but it was never licensed in the UK. Not because it was deemed unsafe, but because the manufacturers never registered it for use in the UK or the US. As it was a private prescription, I was liable for the cost - even though I had private health insurance through my previous employers, as it was deemed "outpatient medication" then it wasn't covered on that. Thankfully it wasn't as expensive as the OP's friend though.

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Posted

Thanks for all your input.

Shouldn't it be possible for her to officially move to Germany, register here and get health insurance from a public provider? Do they have to accept a foreigner from the EU? Wouldn't that solve her problem (provided she finds a German oncologist willing to prescribe the drug)?

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Posted

What are the chances of medical insurance in Germany taking her onboard with such an existing condition?

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Posted

A public insurer would have to insure her I believe. I'm not sure whether she'd be able to get in without a job though.

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Posted

What are the chances of medical insurance in Germany taking her onboard with such an existing condition?

Public health insurance doesn't ask health questions.

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Posted

An EU citizen can, as far as I know, also apply for German health insurance if they are looking for a job and register as unemployed.

However, it may be hard to convince them that she is actually looking for work if she is suffering from cancer. They may well see through this as a ploy to getting better treatment at the expense of the German healthcare system (which this actually is).

Not wanting to sound like a prick here, because obviously someone with a life-threatening illness will do whatever it takes to get better (I know I would too) - however, it shouldn't be the responsibility of the German health system (and those contributing to it) to pick up the tab for deficiencies in another country's health care system.

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Posted

I also wonder if the drug, although available in Germany, would in fact be offered to everyone, particularly those on public insurance. It may well be available, but not covered or only partially covered by insurance. I'm not sure how you would go about checking that.

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Posted

It may well be available, but not covered or only partially covered by insurance. I'm not sure how you would go about checking that.

The Arzneimittel-Richtlinie would probably be a good place to start.

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Posted

I heard that in the past people who required immediate surgery but were on an endless waiting list in the UK were given the underhand advice "go to Paris on vacation and then collapse on the sidewalk". Supposedly the French would not send people home in such a precarious state and treat them instead. This may just be an urban myth, though. Probably it's also easier to pull off for something that requires immediate surgery rather than a prolonged cancer treatment.

I don't see any real option for her to get treatment in Germany other than coming here for work or study and being covered by German public insurance.

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Posted

Shouldn't it be possible for her to officially move to Germany, register here and get health insurance from a public provider? Do they have to accept a foreigner from the EU?

Yes, they would have to accept her, see §9 SGB V Absatz 1 (membership in an EU public health insurance counts the same as in a German one): http://www.sozialgesetzbuch-sgb.de/sgbv/9.html

However, you should first check 2 things:

  • will German public health insurance pay for this drug?
  • will you find an oncologist willing to take such a hit in the monthly drug budget that he gets from the public health insurers, just for 1 patient?

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Posted

If she gets a disability pension in the UK - wouldn't the NHS have to reimburse the cost of her treatment to the German public insurance? And wouldn't that mean an oncologist wouldn't have to take a hit in his budget?

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Posted

The oncologist would still take that hit, she would have the same German Versichertenkarte as everybody else.

Would that disability pension be a long-term incapacity benefit?

http://www.nhs.uk/NHSEngland/Healthcareabroad/movingabroad/Pages/Livingabroad.aspx

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Posted

If she comes over from the UK, stays long term with someone, anmelds and doesn't work, can't she go through the thing that used to be form S1, where the TK or whoever take her on at British expense? Not that I have the smallest clue how it works in practice.

Desperate situation, I hope she finds a solution.

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Posted

Thanks for all your input.

Shouldn't it be possible for her to officially move to Germany, register here and get health insurance from a public provider? Do they have to accept a foreigner from the EU? Wouldn't that solve her problem (provided she finds a German oncologist willing to prescribe the drug)?

I know, thats what I was thinking. But it sounds too easy and good to be true. Come to Germany, get an unskilled part time job (if you're able), live in a youth hostel, get publicly insured from day 1, then quit. Somehow it sounds absurd, yet not absurd at the same time. That can't be right, surely.

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Posted

If she comes over from the UK, stays long term with someone, anmelds and doesn't work, can't she go through the thing that used to be form S1, where the TK or whoever take her on at British expense?

I was thinking of suggesting something along these lines. But as Panda rightly pointed out, there are other questions to check beforehand, otherwise she might undergo the trouble manage to get into the German system but still not get the medication her oncologist suggested.

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Posted

I heard that in the past people who required immediate surgery but were on an endless waiting list in the UK were given the underhand advice "go to Paris on vacation and then collapse on the sidewalk". Supposedly the French would not send people home in such a precarious state and treat them instead. This may just be an urban myth, though.

Isn't that the oddest thing because (despite the NHS's poor reputation) that is exactly what I heard years ago:

Same sentence but just exchange Paris with England...

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Posted

It's Xalkori, generic name: Crizotinib

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Posted

Probably not much help, but Crizotinib is approved for some uses in the UK. It's currently being appraised for the treatment of previously treated non-small-cell lung cancer associated with an anaplastic lymphoma kinase fusion gene - but obviously I have no idea if this is likely to help your friend and I don't think a decision is expected until the summer. There is however, a Phase 3 trial going on at the moment - link here:

http://www.cancerresearchuk.org/cancer-help/trials/a-trial-looking-crizotinib-people-advanced-non-small-cell-lung-cancer

Again, no idea if this would apply (and it might be too late to join anyway) but it would does no harm to take a look.

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Posted

Thank you, I will forward the message

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