Posted by Helen Childs, Partner
Claims for the cost of immunotherapy for mesothelioma sufferers
Immunotherapy is a very promising treatment for mesothelioma. Mavis Nye, a very well known and much loved mesothelioma warrior, had immunotherapy in 2009 as part of a clinical trial. Before she had the immunotherapy she had a life expectancy measured in months. She has been told she is now mesothelioma free.
Immunotherapy is only available privately, and almost always only as a second line treatment (ie after chemotherapy has been undertaken). As a result people are always at least 6 months and often a good year post diagnosis before they are suitable candidates for immunotherapy.
Immunotherapy is also expensive, with a full course of immunotherapy often costing £250,000 plus. It’s rarely covered by private healthcare providers.
The efficacy of immunotherapy is still being assessed, but current evidence suggests that there’s about a 20% response rate. Some people’s response to immunotherapy is very good, and it can extend their lifespans considerably.
How does this impact on mesothelioma compensation?
In mesothelioma and other life limiting conditions we advise on the merits of settling their claim in their lifetime or their estate settling it after their death. Usually a fatal settlement is more valuable, but sometimes it isn’t, which means those claims have to be especially fast tracked.
Immunotherapy adds another complication to this. Usually an individual will have the first cycle of immunotherapy (cost c.£35K) and decide whether to proceed with the treatment dependent on the results of CT scans, and how well they tolerate the immunotherapy.
This means that in a case where it’s an imperative to settle in lifetime – because the living claim is more valuable – we are able to claim the full cost of the first cycle of immunotherapy plus 20% of the balance, because usually the immunotherapy treatment will not have taken place yet. Obviously, if the individual only undergoes the first cycle, or if they deteriorate before they are even able to undergo the first cycle, the settlement will be about 45-80K more than the actual cost incurred.
Until a settlement within the last week or so, we would have had to advise our clients that early settlement (including the cost of part of the immunotherapy) is always a gamble, because if they responded well to the immunotherapy there will have been a shortfall of £190K, something they would have to find from the balance of their claim or savings.
However a claim has recently been settled for an individual personally on the basis that if immunotherapy is recommended by their treating physicians the defendants will fund it. This is known as a “periodical payments” order. We hope that this will become a commonplace order, as it will remove one of the many uncertainties that claimants and their famiilies currently have to face.
For information about a claim for mesothelioma or treatment please contact our team anytime.
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