MSPs have called for a major shake-up in the way patients access new medicines, saying Scottish Government reviews have done little to address significant problems in the system.
Holyrood's Health Committee said it remained concerned that very little had been done despite recommendations to make the system better. But it rejected calls from the Scottish Conservatives for Scotland to follow England and set up a cancer drugs fund.
Health Secretary Alex Neil pledged to consult on the committee's recommendations.
In November it was announced that Professor Philip Routledge, of Cardiff University and Prof Charles Swainson, the former medical director of NHS Lothian, would conduct a review of processes that mean hundreds of life-saving or life-changing drugs are restricted for use in Scotland.
The pair made a number of recommendations, including letting patients and health professionals observe the appraisal process.
The committee said the recommendations in the reviews did little to address the barriers that exist.
Campaigners complained that drugs for diseases such as cancer are available in other parts of the UK and Europe but are not routinely offered to NHS patients in Scotland. Patients instead have to apply for drugs not approved for widespread use by the Scottish Medicines Consortium (SMC) on a case-by-case basis by submitting an Individual Patient Treatment Request (IPTR).
The Government ordered an initial review over a year ago, after critics claimed a cross-border divide in availability of new medications had been created. The probe, carried out by Scotland's Chief Medical Officer, Sir Harry Burns, and the Chief Pharmaceutical Officer, Professor Bill Scott, decided to allow IPTR to bed in before a further review.
Pensioner Joyce Juszczak, 66, was refused the drug eculizumab for a life-threatening blood condition.
Mrs Juszczak, from Gourock, Inverclyde, was only given eculizumab when she suffered a potentially fatal blood clot. She went seven months without the treatment after a failed IPTR and subsequent appeals.
MSPs urged the Scottish Government to review previous decisions made in relation to IPTRs. It said the central difficulty of the IPTR system was the requirement for patients to prove exceptional circumstances.
Their report said: "It is believed that, in its current form, this approach acts as a barrier to accessing drugs clinicians believe their patients need."
It added: "The Scottish Government must outline steps it plans to take that will improve the process."
An interim recommendation from the reviews for a new fund to cover the cost of medicines for people with rare medical conditions has already been put in place, with the Scottish Government committing £21 million to it.
The reviews also recommend that the SMC meets in public so patients and others can see how the system operates, and that it should set up a "citizen's jury" to hear public opinion on the availability of new medicine.
Mr Neil now plans to meet UK minister Earl Howe to seek greater clarification from Westminster on its new drug pricing structure.
Mark Flannagan, chief executive of Beating Bowel Cancer, said: "We have had consultation after consultation, review after review. Patients now want to see the Scottish Government taking immediate and decisive action to fix the problem."
"We cannot continue with a system that has thrown up high profile injustice after injustice."
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