Health secretary backs Herceptin use
pharmafile | November 10, 2005 | News story | |Â Â Â
North Stoke PCT will provide a mother of four with breast cancer drug Herceptin following mounting political and media pressure.
Elaine Barber threatened to take the PCT to court when it refused to fund treatment of her early-stage breast cancer with Herceptin, even though it is only licensed to treat the advanced stage of the disease.
The PCT had said it wouldn't fund the treatment because the drug lacked long-term safety or cost-effectiveness data, but reversed that decision after intervention by Health Secretary Patricia Hewitt.
In a statement the PCT said: "North Stoke PCT is confident that the process that has been followed in considering Elaine's appeal has been thorough and rigorous and soundly based upon the evidence that is currently available."
Funding the use of Herceptin will put additional cost pressures on the already stretched finances of the PCT, but it stressed its original decision was not based on the absolute cost of the drug.
The drug's manufacturer Roche does not intend to submit Herceptin to the EMEA for approval for early stage breast cancer until February next year, meaning the earliest a decision could be made on it would be July 2006.
Prescribing Herceptin for early stage breast cancer is up to individual doctors but Hewitt has been an enthusiastic supporter of the drug.
Last month she told PCTs they had to decide whether to support clinicians' decisions to prescribe Herceptin, but that they should not refuse to fund it solely on the grounds of cost.
"I know that some PCTs are already under financial pressure and may have to make difficult trade-offs in priorities to fund this new treatment for women who want it and whose clinicians want it for them. Although it will not be easy, I believe it is the right thing to do," Hewitt said, speaking at a lobbying event for charity Breakthrough Breast Cancer.
Some NHS bosses have expressed fears that Hewitt's actions in effectively overruling the PCT's original decision will give other trusts no choice but to fund the treatment.
One PCT chief executive told the BBC: "I don't think any trust will be able to say no to Herceptin now, even if there are legitimate concerns about safety and cost. No trust would be foolish enough."
Those concerns do exist and Herceptin's evidence base has been criticised by an editorial in medical journal The Lancet.
"The best thing that can be said about Herceptin's efficacy and safety for the treatment of early breast cancer is that the available evidence is insufficient to make reliable judgments," the journal said.
Nigel Edwards, director of policy at the NHS Confederation, said: "We are concerned that primary care trusts are being put in an almost impossible position by growing pressure to bypass systems established to protect patients. We hope that The Lancet editorial will prove to be a timely intervention."
At the beginning of October the Health Secretary also announced that all women diagnosed with early stage breast cancer would be tested for suitability for treatment with Herceptin. When Herceptin receives EMEA approval Hewitt then wants the drug to made available to the NHS as quickly as possible.
"I want the licence for Herceptin to be granted as quickly as possible, without compromising people's safety, and it to be available within weeks of the licence being given," she said.
Herceptin will benefit from NICE's new fast track process, which was put into place following media interest in a patient campaign for quicker access to the drug.
Of the 35,000 women diagnosed with breast cancer each year, about 20,000 will be suitable for HER2 testing and about 5,000 of these women may benefit from Herceptin.
The Department of Health estimates the drug could save around 1,000 lives a year, at an annual cost of about £100 million.
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