As per a team of doctors, paying for the cost of the new
cancer drug Herceptin, which is given to
breast cancer patients, could mean that other cancer patients may have to be denied other treatments.
The National Institute for Health and Clinical Excellence (Nice), has said that patients with early breast cancer should be given Herceptin post surgery, chemotherapy and radiotherapy, if there were chances of their cancer returning.
However, they have not provided any extra funds and have also said that the Herceptin
treatment should be paid by primary care trusts. Making the drug available would help save hundreds of lives according to cancer experts, and there have been sustained campaigns for easy access to Herceptin on the NHS. However, doctors have warned that funding the drug would mean making cuts elsewhere, including denying other patients some treatments.
The HER2 protein fuels breast tumors growth, and there are about 20 percent of breast cancers which are HER2 positive. The drug Herceptin targets this HER2 protein and works for almost 20 to 25 percent of breast cancer patients.
A team of doctors at the Norfolk and Norwich University Hospital NHS Trust, and the University of East Anglia, made an illustrated calculation of the funding required and the cutbacks required for the funding. The Herceptin treatment which costs approximately £20,000 per year would mean £1.9 million per year for treatment of 75 patients in terms of drug costs alone.
The supplementary costs of testing, monitoring, drug administration and pharmacy preparations when added to this base cost, hiked the figure up to £2.3 million. Doctors Ann Barrett, Tom Roques and Matthew Small then estimated that to save £1.9 million they would have to cut chemotherapy and palliative care treatments.
In this way they could fund for Herceptin treatment for 75 patients, if 355 other patients who were being given adjuvant treatment like chemotherapy and radiotherapy were not treated, 16 of whom would be cured. Or else 208 patients being given palliative chemotherapy were not treated for balancing the cost of Herceptin treatment. And they would still need £500,000 from some other source.
The researchers, who have published their findings in the British Medical Journal, said that the actual cost of the Herceptin treatment would be in "the other patients not treated, whether they are patients with cancer or those with other conditions".
"The sum of £1.9m would enable us to treat 75 patients with Herceptin, but at four times the cost of the adjuvant treatments. These treatments have been proved to be clinically effective and their estimated cost effectiveness is far greater than that currently expected for Herceptin," they added.
The doctors wrote in their report published in the BMJ: "These untreated patients will be people we know. We will be the ones to tell them they are not getting treatment that has been proved to be effective and which costs relatively little, because it is not the treatment of the moment. These results are obviously not definitive, but illustrate the fundamental challenge facing the NHS - the tension between national priority setting and local implementation."
