A cancer charity has hit out at the "enormous inequality" in the system for prescribing new medicines.
Beating Bowel Cancer claimed that many patients suffering from the disease in Scotland were "simply unable to access treatment because of where they live".
It also said it remained to be seen whether a review of the system for approving new medicines would "translate into fairer drug access for patients".
The charity voiced its concerns in a submission to MSPs on Holyrood's Health Committee, who will consider the controversial issue of access to medicines when they meet tomorrow.
Last week, it emerged that bowel cancer sufferer Maureen Fleming, 63, is considering moving to England after being refused the drug cetuximab in Scotland.
Her consultants say the grandmother-of-10, from Bonhill, West Dunbartonshire, may get the life-prolonging treatment on the NHS south of the border.
Labour leader Johann Lamont raised Mrs Fleming's plight with First Minister Alex Salmond, describing her as a "health refugee".
Beating Bowel Cancer said that for patients across Scotland "securing fair access to drugs can be a lengthy, confusing and frustrating experience"
In its submission to MSPs, the charity said: "We know that the first question that comes to bowel cancer patients' minds after diagnosis is not 'will I survive?' Instead they ask 'what are my options?'
"Unfortunately, those options differ depending on which side of the border they live, with patients in Scotland three times less likely to gain access to a cancer drug, which is not routinely funded, than people in England."
It said this could result in patients having to pay "extremely high treatment costs" to get the drugs, moving to another part of the country where treatments are available or simply going without.
An independent review of the system recently recommended the Scottish Medicines Consortium (SMC) - the body which approves new medicines for the NHS in Scotland - should meet in public so that patients and drugs companies could see how it works.
But Beating Bowel Cancer said while the measures recommended in the review could improve transparency and accountability, it added: "It remains to be seen whether those improvements will translate into fairer drug access for patients.
"Our concern is that the review recommendations will merely serve to provide patients the opportunity to clearly 'see inside' a system that still does not meet their needs and which continues to be a source of frustration because the drugs that they need remain out of reach in Scotland."
Further recommendations were made on how the Individual Patient treatment Request (IPTR) process, used by patients to try to access drugs not yet approved for NHS use, could be improved.
However, Beating Bowel Cancer said feedback from cancer sufferers was that this would "not do enough to improve a system that, in their view, was stacked against them from the outset".
Overall, the charity said: "The system retains enormous inequality because bowel cancer patients in Scotland are in many cases simply unable to access treatment because of where they live."
In its submission, the SMC said it believed the concerns of cancer specialists and patients had "largely" resulted from the decision to set up a cancer drugs fund in England.
It accepted this was "challenging for patients" but added the ability to make different decisions was a consequence of having a devolved Scottish Parliament.
The SMC also told MSPs that most of the recommendations from the New Medicines Review were "likely to result in only marginal change to the decisions reached".
It added: "It is expected that by enhancing processes to engage patients, the public and the pharmaceutical industry there will be better stakeholder engagement and buy-in to the decisions. It is not a given that this will be achieved. "
The organisation also cautioned that implementing such measures would "require major changes to the current ways of working" and said there may be unintended consequences.
A Scottish Government spokeswoman said: "Scotland has one of the fastest and most efficient medicine review processes anywhere in the world, however we can't overlook the concerns raised by clinicians, charities and patients about access to medicines.
"That is why we commissioned an independent review, which provides some key recommendations on how to improve access arrangements for new medicines in Scotland to make them better than ever before.
"Many of the recommendations focus around making sure the system is as open and transparent as possible, and to improve information for patients and the public about how decisions are taken on which medicines to prescribe.
"We will consult on these together with the recommendations from the Health and Sport Committee as we want everyone to have their say on how we make sure that the Scotland has the best system possible."
Tory health spokesman Jackson Carlaw said: "The SNP's stubbornness to tackle this issue head-on means that thousands of cancer sufferers in Scotland are receiving inferior treatment compared with those in England.
"Cancer charities and doctors agree that the system in Scotland is not working and the Health Secretary can no longer ignore the growing consensus for a cancer drugs fund."
Mr Carlaw, also the Conservative deputy leader, added: "Being diagnosed with cancer is traumatic enough without people having to then worry about whether they might not get the best treatment.
"Being in government is all about choices and the SNP have chosen to spend millions on giving free prescriptions to people like the First Minister.
"It is high time they started providing cancer patients in Scotland with the world-class treatment they deserve."
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