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Exceptional case system ‘in chaos’

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Patients diagnosed with rare conditions not covered by NICE guidance face a postcode lottery for treatment, according to an audit involving 62 PCTs.

The Rarer Cancers Forum asked trusts about their policies on access to drugs that were either yet to be appraised by NICE or outside its remit via the ‘exceptional case’ process.

Over the past 20 months, around 5,000 patients had been forced to demonstrate they were exceptional cases and receive funding for treatments not usually provided by the NHS.

The audit also uncovered variations in the handling of such requests, with some PCTs having approved all and others none. The forum described the system as ‘in chaos’ and called for national guidance to bring consistency to trust policy.

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